Myocardial enhancement on magnetic resonance imaging with gadolinium-diethylenetriamine pentaacetic acid and improvement of left ventricular function in patients with dilated cardiomyopathy.
OBJECTIVE
This study evaluated the significance of myocardial gadolinium-diethylenetriamine pentaacetic acid (Gd-DTPA) enhancement on magnetic resonance imaging for the improvement of left ventricular function in patients with dilated cardiomyopathy.


METHODS
Twenty-seven patients with dilated cardiomyopathy (mean age 59 +/- 11 years) were studied. The magnitude of myocardial Gd-DTPA enhancement was quantitatively assessed using signal intensity ratio and compared to changes in left ventricular function and adverse cardiac events during a relatively long follow-up period.


RESULTS
Regional high signal intensity ratio, defined as > or = mean + 2SD in seven normal subjects, was found in 14 patients: in three or more regions out of five myocardial regions analyzed in six patients (extensive enhancement) and in only one or two regions in eight patients (limited enhancement). The remaining 13 patients had no high signal ratio in any of the five regions analyzed (no enhancement). During the follow-up period of 3.9 +/- 1.9 years, four patients died of cardiac causes. The incidence of cardiac death was 33.3% in patients with extensive enhancement, 12.5% in those with limited enhancement and 7.7% in those without enhancement, but there was no statistical difference. Mild improvement in fractional shortening was observed in patients without enhancement during the follow-up (19 +/- 4%-->27 +/- 10%, p = 0.03).


CONCLUSIONS
Evaluation of myocardial Gd-DTPA enhancement on magnetic resonance imaging may provide useful prognostic information for patients with dilated cardiomyopathy.
Akisawa
Masafumi
M
Department of Medicine and Geriatrics, Kochi Medical School, Kohasu, Oko-cho, Nankoku, Kochi 783-8505.
Matsumura
Yoshihisa
Y
Kitaoka
Hiroaki
H
Yamasaki
Naohito
N
Takata
Jun
J
Doi
Yoshinori
Y
D000328:Adult; D000368:Aged; D006328:Cardiac Catheterization; D002311:Cardiomyopathy, Dilated / Q000175:diagnosis / Q000503:physiopathology*; D003287:Contrast Media; D018618:Echocardiography, Doppler, Color; D018619:Echocardiography, Doppler, Pulsed; D015716:Electrocardiography, Ambulatory; D005260:Female; D005500:Follow-Up Studies; D019786:Gadolinium DTPA; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016277:Ventricular Function, Left / Q000502:physiology*
D003287:Contrast Media; D019786:Gadolinium DTPA