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CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2021; 31(01): 116-123
DOI: 10.1055/s-0041-1730133
Original Article

Diagnostic Role of Cardiovascular Magnetic Resonance Imaging in Dilated Cardiomyopathy

Nehal Singla
1   Department of Radio-Diagnosis, PGIMER and RML Hospital, New Delhi, India
,
Shibani Mehra
1   Department of Radio-Diagnosis, PGIMER and RML Hospital, New Delhi, India
,
Umesh C. Garga
1   Department of Radio-Diagnosis, PGIMER and RML Hospital, New Delhi, India
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Abstract

Aims The purpose of the study was to compare the accuracy of cardiac magnetic resonance (CMR) with echocardiography for the evaluation of ventricular dysfunction in patients of dilated cardiomyopathy (DCM). Further, we evaluated the potential of CMR for myocardial tissue characterization.

Design Prospective observational.

Materials and Methods A total of 30 patients with suspected DCM prospectively underwent cardiac magnetic resonance (MR) using a 1.5 Tesla MR scanner, with appropriate phased-array body coils. Dynamic sequences after injection of 0.1 mmol/kg of body weight of gadolinium-based intravenous contrast (Magnevist) were acquired for each patient, after which delayed images were obtained at an interval of 12 to 15 minutes. Myocardial tagging was performed in all patients for assessment of wall motion abnormalities. Each MR examination was interpreted with two radiologists for chamber dimensions and ventricular dysfunction as well as morphologic characteristics with disagreement resolved by consensus. All patients included in the study were taken up for MR evaluation after cardiological evaluation through echocardiography and the results for both the studies were compared. Data were analyzed through standard statistical methods.

Conclusion CMR is a comprehensive diagnostic tool, which can estimate the ventricular function more precisely than echocardiography. CMR reliably differentiates between ischemic and nonischemic etiologies of DCM based on patterns of late gadolinium enhancement (LGE) and based on the presence or absence of LGE, which helps to estimate the degree of myocardial fibrosis. Thereby it can be a useful tool in establishing risk stratification, predicting prognosis, and thus instituting appropriate therapy in DCM patients.

Keywords

cardiac magnetic resonance imaging - dilated cardiomyopathy - late gadolinium enhancement


Publication History

Article published online:
31 May 2021

© 2021. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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  • References

  • 1 Maron BJ, Towbin JA, Thiene G. et al. American Heart Association, Council on Clinical Cardiology, Heart Failure and Transplantation Committee, Quality of Care and Outcomes Research and Functional Genomics and Translational Biology Interdisciplinary Working Groups, Council on Epidemiology and Prevention. Contemporary definitions and classification of the cardiomyopathies: an American Heart Association Scientific Statement from the Council on Clinical Cardiology, Heart Failure and Transplantation Committee; Quality of Care and Outcomes Research and Functional Genomics and Translational Biology Interdisciplinary Working Groups; and Council on Epidemiology and Prevention. Circulation 2006; 113 (14) 1807-1816
    CrossrefPubMedGoogle Scholar
  • 2 Mestroni L, Brun F, Spezzacatene A, Sinagra G, Taylor MR. Genetic causes of dilated cardiomyopathy. Prog Pediatr Cardiol 2014; 37 (1-2) 13-18
    CrossrefPubMedGoogle Scholar
  • 3 Elliott P, Andersson B, Arbustini E. et al. Classification of the cardiomyopathies: a position statement from the European Society Of Cardiology Working Group on Myocardial and Pericardial Diseases. Eur Heart J 2008; 29 (02) 270-276
    CrossrefPubMedGoogle Scholar
  • 4 Jefferies JL, Towbin JA. Dilated cardiomyopathy. Lancet 2010; 375 (9716) 752-762
    CrossrefPubMedGoogle Scholar
  • 5 Charron P, Arad M, Arbustini E. et al. European Society of Cardiology Working Group on Myocardial and Pericardial Diseases. Genetic counselling and testing in cardiomyopathies: a position statement of the European Society of Cardiology Working Group on Myocardial and Pericardial Diseases. Eur Heart J 2010; 31 (22) 2715-2726
    CrossrefPubMedGoogle Scholar
  • 6 Dec GW, Fuster V. Idiopathic dilated cardiomyopathy. N Engl J Med 1994; 331 (23) 1564-1575
    CrossrefPubMedGoogle Scholar
  • 7 Slavich M, Florian A, Bogaert J. The emerging role of magnetic resonance imaging and multidetector computed tomography in the diagnosis of dilated cardiomyopathy. Insights Imaging 2011; 2 (04) 453-469
    CrossrefPubMedGoogle Scholar
  • 8 McCrohon JA, Moon JC, Prasad SK. et al. Differentiation of heart failure related to dilated cardiomyopathy and coronary artery disease using gadolinium-enhanced cardiovascular magnetic resonance. Circulation 2003; 108 (01) 54-59
    CrossrefPubMedGoogle Scholar
  • 9 Belloni E, De Cobelli F, Esposito A. et al. MRI of cardiomyopathy. AJR Am J Roentgenol 2008; 191 (06) 1702-1710
    CrossrefPubMedGoogle Scholar
  • 10 Fujita N, Duerinekx AJ, Higgins CB. Variation in left ventricular regional wall stress with cine magnetic resonance imaging: normal subjects versus dilated cardiomyopathy. Am Heart J 1993; 125 (5, Pt 1) 1337-1345
    CrossrefPubMedGoogle Scholar
  • 11 Pritchett AM, Mahoney DW, Jacobsen SJ, Rodeheffer RJ, Karon BL, Redfield MM. Diastolic dysfunction and left atrial volume: a population-based study. J Am Coll Cardiol 2005; 45 (01) 87-92
    CrossrefPubMedGoogle Scholar
  • 12 Lang RM, Bierig M, Devereux RB. et al. Chamber Quantification Writing Group; American Society of Echocardiography’s Guidelines and Standards Committee; European Association of Echocardiography. Recommendations for chamber quantification: a report from the American Society of Echocardiography’s Guidelines and Standards Committee and the Chamber Quantification Writing Group, developed in conjunction with the European Association of Echocardiography, a branch of the European Society of Cardiology. J Am Soc Echocardiogr 2005; 18 (12) 1440-1463
    CrossrefPubMedGoogle Scholar
  • 13 Barison A, Masci PG, Emdin M. Fibrosis and mortality in patients with dilated cardiomyopathy. JAMA 2013; 309 (24) 2547
    CrossrefPubMedGoogle Scholar
  • 14 Mann DL, Bristow MR. Mechanisms and models in heart failure: the biomechanical model and beyond. Circulation 2005; 111 (21) 2837-2849
    CrossrefPubMedGoogle Scholar
  • 15 Baig MK, Mahon N, McKenna WJ. et al. The pathophysiology of advanced heart failure. Am Heart J 1998; 135 (06) (Suppl. 02) S216-S230
    CrossrefPubMedGoogle Scholar
  • 16 Beltrami CA, Finato N, Rocco M. et al. The cellular basis of dilated cardiomyopathy in humans. J Mol Cell Cardiol 1995; 27 (01) 291-305
    CrossrefPubMedGoogle Scholar
  • 17 Wu E, Judd RM, Vargas JD, Klocke FJ, Bonow RO, Kim RJ. Visualisation of presence, location, and transmural extent of healed Q-wave and non-Q-wave myocardial infarction. Lancet 2001; 357 (9249) 21-28
    CrossrefPubMedGoogle Scholar
  • 18 Koito H, Suzuki J, Ohkubo N, Ishiguro Y, Iwasaka T, Inada M. Gadolinium-diethylenetriamine pentaacetic acid enhanced magnetic resonance imaging of dilated cardiomyopathy: clinical significance of abnormally high signal intensity of left ventricular myocardium [in Japanese]. J Cardiol 1996; 28 (01) 41-49
    Google Scholar
  • 19 de Leeuw N, Ruiter DJ, Balk AH, de Jonge N, Melchers WJ, Galama JM. Histopathologic findings in explanted heart tissue from patients with end-stage idiopathic dilated cardiomyopathy. Transpl Int 2001; 14 (05) 299-306
    CrossrefPubMedGoogle Scholar