Cardiac magnetic resonance imaging in Alström syndrome.
BACKGROUND
A case series of the cardiac magnetic resonance imaging findings in seven adult Alström patients.


METHODS
Seven patients from the National Specialist Commissioning Group Centre for Alström Disease, Torbay, England, UK, completed the cardiac magnetic resonance imaging protocol to assess cardiac structure and function in Alström cardiomyopathy.


RESULTS
All patients had some degree of left and right ventricular dysfunction. Patchy mid wall gadolinium delayed enhancement was demonstrated, suggesting an underlying fibrotic process. Some degree of cardiomyopathy was universal. No evidence of myocardial infarction or fatty infiltration was demonstrated, but coronary artery disease cannot be completely excluded. Repeat scanning after 18 months in one subject showed progression of fibrosis and decreased left ventricular function.


CONCLUSIONS
Adult Alström cardiomyopathy appears to be a fibrotic process causing impairment of both ventricles. Serial cardiac magnetic resonance scanning has helped clarify the underlying disease progression and responses to treatment. Confirmation of significant mutations in the ALMS1 gene should lead to advice to screen the subject for cardiomyopathy, and metabolic disorders.
Loudon
Margaret A
MA
South Devon NHS Trust, Torbay Hospital, Torquay, UK. mloudon@doctors.org.uk
Bellenger
Nicholas G
NG
Carey
Catherine M
CM
Paisey
Richard B
RB
D000328:Adult; D009202:Cardiomyopathies / Q000175:diagnosis / Q000473:pathology* / Q000503:physiopathology; D005260:Female; D005682:Gadolinium; D006352:Heart Ventricles / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D007089:Image Enhancement; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000473:pathology / Q000503:physiopathology; D018497:Ventricular Dysfunction, Right / Q000175:diagnosis / Q000473:pathology / Q000503:physiopathology; D055815:Young Adult
D005682:Gadolinium