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Heart Lung Circ. 2012 Jan;21(1):30-5. doi: 10.1016/j.hlc.2011.09.005. Epub 2011 Nov 3.

Cardiac magnetic resonance imaging predicts recovery of left ventricular function in acute onset cardiomyopathy.

Author information

  • 1The Alfred Hospital, Melbourne, Victoria, Australia; St Vincent's Hospital, Melbourne, Victoria, Australia.

Abstract

BACKGROUND:

In acute onset cardiomyopathy, acute myocarditis is an important cause, as it is associated with a greater likelihood of recovery of cardiac function and its presence may direct specific therapies. Myocarditis can be detected by cardiac magnetic resonance imaging (CMR); however its diagnostic utility and relation to prognosis in acute onset cardiomyopathy are unknown.

METHODS:

We performed CMR on 61 patients with acute onset cardiomyopathy and a left ventricular ejection fraction (LVEF) <55%. CMR included assessment of myocardial function, relative myocardial oedema, myocardial inflammation (using global relative enhancement [GRE] of the myocardium 4 minutes post Gad-DTPA contrast) and necrosis or fibrosis (with late gadolinium enhancement [LGE]). Patients were followed up at six months to evaluate LVEF, morbidity and mortality.

RESULTS:

There was a greater improvement in LVEF at follow up in those with myocardial inflammation identified by elevated GRE compared to those without (mean increase 19.2±2.5% vs. 6.7±1.7%, p<0.001). However, the presence of myocardial oedema or LGE alone was not associated with a greater recovery of LVEF (p=NS for both). Myocardial inflammation in patients with a baseline LVEF<35% was also associated with a greater recovery of LVEF (mean increase 21.5±2.9% vs. 9.1±3.0%, p<0.01).

CONCLUSION:

Myocardial inflammation identified by an elevated GRE predicts recovery of LV function in patients with acute onset cardiomyopathy.

Copyright © 2011 Australasian Society of Cardiac and Thoracic Surgeons and the Cardiac Society of Australia and New Zealand. Published by Elsevier B.V. All rights reserved.

PMID:
22055931
[PubMed - indexed for MEDLINE]
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