[Evaluation of chronic morphological changes in the latissimus dorsi, after cardiomyoplasty, with magnetic resonance].
OBJECTIVE
Long term clinical and hemodynamic benefits of dynamic cardiomyoplasty (DC) have been reported. However, no information is available about long-term morphological changes in the wrapped latissimus dorsi (LD) muscle in humans.


METHODS
The latissimus dorsi muscle flap was evaluated by magnetic resonance imaging (MRI) in 5 patients submitted to DC for treatment of severe dilated cardiomyopathy. All patients were studied from 24 to 52 months after the surgical procedure at the time of the cardiomyostimulator replacement. In the interim, LD was stimulated with burst of 6 pulses (burst duration 185 msec, burst freq 30Hz) synchronized to every cardiac contraction with a maximum of 100 LD contractions/min. Images were acquired on a GE Sigma 1.5 T system (TE = 25ms, TR = R- Rx2, slice thickness 8mm).


RESULTS
The thickness of was 7.6 +/- 0.8mm. In addition, the signal intensity of the LD was compared with that of thoracic skeletal muscle and was found to be increased (2.19 +/- 0.42). The signal intensity was similar to that of subcutaneous fat in those images.


CONCLUSIONS
Morphologic changes in the wrapped LD muscle consistent with fatty degeneration occur after DC and can be detected by MRI. Further studies will be necessary to demonstrate the clinical significance of such LD muscle flap changes.
Kalil Filho
R
R
Instituto do Coração do Hospital das Clínicas-FMUSP, São Paulo.
Bocchi
E
E
Rosemberg
L
L
Bacal
F
F
Moreira
L F
LF
Ferreira
B M
BM
Stolf
N A
NA
Magalhães
A A
AA
Bellotti
G
G
Jatene
A
A
D000328:Adult; D009202:Cardiomyopathies / Q000503:physiopathology / Q000601:surgery*; D018421:Cardiomyoplasty; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009119:Muscle Contraction; D018482:Muscle, Skeletal / Q000473:pathology* / Q000503:physiopathology
Avaliação das alterações morfológicas crônicas do músculo grande dorsal, após cardiomioplastia, através da ressonância magnética.