Delayed hyperenhancement magnetic resonance imaging is useful in predicting functional recovery of nonischemic left ventricular systolic dysfunction.
BACKGROUND
About 25% of the patients with nonischemic left ventricular (LV) systolic dysfunction improve spontaneously. However, the predictors for functional improvement are not known. We hypothesized that myocardial fibrosis, assessed by cardiac magnetic resonance (CMR) imaging, may predict the reversibility of nonischemic LV systolic dysfunction.


RESULTS
CMR was performed in 46 patients. Baseline and follow-up echocardiography was performed to assess the recovery of LV function. There were 24 patients with absence of delayed hyperenhancement (group 1) and 22 patients with delayed hyperenhancement (group 2). There were significant difference for the follow-up LV end-diastolic dimension (56.2 +/- 7.3 versus 62.6 +/- 11.9), LV end-systolic dimension (43.2 +/- 9.2 versus 52.8 +/- 12.6), and LV ejection fraction (LVEF) (46.8 +/- 12.4% versus 31.6 +/- 11.3%). Follow-up echocardiography of 19/24 (79.2%) patients in group 1 showed functional recovery, whereas only 2/22 (9.1%) patient in group 2 showed functional recovery. The absence of delayed hyperenhancement was associated with sensitivity, specificity, positive predictive value, and negative predictive value of 90.5%, 79.2%, 80.0%, and 90.9%, respectively.


CONCLUSIONS
Absence of delayed hyperenhancement demonstrated excellent sensitivity and negative predictive value in predicting functional recovery of nonischemic LV systolic dysfunction.
Park
Sungha
S
Division of Cardiology, Yonsei University College of Medicine, Yonsei Cardiovascular Center, Seodaemun-gu, Shinchondong, Seoul, South Korea 120-752.
Choi
Byoung Wook
BW
Rim
Se-Joong
SJ
Shim
Chi Young
CY
Ko
Young-Guk
YG
Kang
Seok-Min
SM
Ha
Jong-Won
JW
Jang
Yangsoo
Y
Chung
Namsik
N
Choe
Kyu-Ok
KO
Cho
Seung-Yun
SY
D002311:Cardiomyopathy, Dilated / Q000473:pathology / Q000503:physiopathology*; D016022:Case-Control Studies; D003287:Contrast Media; D018618:Echocardiography, Doppler, Color; D005260:Female; D005355:Fibrosis; D005500:Follow-Up Studies; D019786:Gadolinium DTPA; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology*; D011237:Predictive Value of Tests; D020127:Recovery of Function / Q000502:physiology*; D012680:Sensitivity and Specificity; D013318:Stroke Volume / Q000502:physiology; D013599:Systole / Q000502:physiology; D018487:Ventricular Dysfunction, Left / Q000473:pathology / Q000503:physiopathology*
D003287:Contrast Media; D019786:Gadolinium DTPA