Delayed enhancement cardiac magnetic resonance imaging reveals typical patterns of myocardial injury in patients with various forms of non-ischemic heart disease.
BACKGROUND
Late gadolinium-hyperenhancement (LHE) on cardiac magnetic resonance imaging (CMR) has been linked to cardiovascular risk in ischemic and non-ischemic heart disease. We aimed to systematically categorize LHE-patterns in a variety of non-ischemic heart diseases (NIHD) and to explore their relationship with left ventricular (LV) function.


METHODS
In a retrospective database search, 156 patients with NIHD who exhibited LHE on CMR were identified. All images were re-analyzed stepwise. LHE was correlated to LV functional parameters. Cardiac magnetic resonance (CMR) was conducted on 1.5 T scanners.


RESULTS
Typically, LHE spared the subendocardium. Consistent LHE-patterns were observed in myocarditis, hypertrophic and dilated cardiomyopathy and systemic vasculitis. No conclusive LHE-patterns were observed in patients with aortic stenosis, arterial hypertension, lupus erythematosus, sarcoidosis, ventricular arrhythmia and in a mixed subgroup of rare NIHDs. There was no significant relationship between LHE and ejection fraction. There was no correlation between enddiastolic volume and LHE in either myocarditis (P = 0.13) or dilated cardiomyopathy (P = 0.62). LHE was unrelated to LV-mass in aortic stenosis (P = 0.13) and hypertrophic cardiomyopathy (P = 0.38).


CONCLUSIONS
Distinct LHE patterns exist in various NIHDs and their visualization may ultimately aid diagnosis. Unlike in ischemic heart disease, the structure-function relationship does not appear to be strong.
Bohl
Steffen
S
Franz Volhard Clinic, Charité Campus Buch, University Medicine Berlin, HELIOS Clinics Schwanebecker Chaussee 50, 13125 Berlin, Germany. steffen.bohl@charite.de
Wassmuth
Ralf
R
Abdel-Aty
Hassan
H
Rudolph
André
A
Messroghli
Daniel
D
Dietz
Rainer
R
Schulz-Menger
Jeanette
J
D003287:Contrast Media; D019786:Gadolinium DTPA; D006331:Heart Diseases / Q000473:pathology* / Q000503:physiopathology; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008279:Magnetic Resonance Imaging; D009206:Myocardium / Q000473:pathology*; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D016277:Ventricular Function, Left
D003287:Contrast Media; D019786:Gadolinium DTPA