Late gadolinium-enhanced cardiovascular magnetic resonance identifies patients with standardized definition of ischemic cardiomyopathy: a single centre experience.
BACKGROUND
Definition of ischemic cardiomyopathy (IC) is not always obvious, which is why new criteria based on prognosis and the extent of the coronary artery disease (CAD) have been proposed. In the present study, we assess the capability of late gadolinium-enhanced cardiovascular magnetic resonance (CMR) for predicting IC as determined by standardized criteria previously reported.


RESULTS
123 patients with heart failure (HF) and left ventricular (LV) systolic dysfunction, underwent both late gadolinium-enhanced CMR and coronary angiography 37/123 (30%) of patients were assigned to the IC group and 86/123 (70%) to the non-IC group. Subendocardial late gadolinium enhancement (LGE) was found in 35/37 (94%) of patients in the IC group, whereas only 12/86 (14%) had this distribution in the non-IC group (p<0.001). There was a significant positive correlation between the extent of subendocardial LGE and that of the CAD as determined by the CAD Prognostic Index (r=0.78, p<0.01), the number of coronary stenoses > or = 50% (r=0.76, p<0.01) and the number of coronary stenoses of any percentage (r=0.70, p<0.01).


CONCLUSIONS
In patients with HF and LV systolic dysfunction presence of subendocardial LGE makes an excellent indicator of underlying significant CAD, and the extent of the LGE correlates with the severity of the disease. It is therefore appealing as a method for diagnosing IC.
Soriano
Carlos J
CJ
Servicio de Cardiología, Consorcio Hospital General Universitario de Valencia, Spain.
Ridocci
Francisco
F
Estornell
Jordi
J
Pérez-Boscá
José L
JL
Pomar
Francisco
F
Trigo
Alberto
A
Planas
Ana
A
Nadal
Mercedes
M
Jacas
Victoria
V
Martinez
Vicente
V
Paya
Rafael
R
D000368:Aged; D002303:Cardiac Output, Low / Q000150:complications / Q000175:diagnosis; D002319:Cardiovascular System / Q000473:pathology*; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000175:diagnosis; D004699:Endocardium / Q000473:pathology; D005260:Female; D005682:Gadolinium; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000175:diagnosis*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012720:Severity of Illness Index; D013599:Systole; D018487:Ventricular Dysfunction, Left / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology
D005682:Gadolinium