Identifying the etiology: a systematic approach using delayed-enhancement cardiovascular magnetic resonance.
In patients who have heart failure, treatment and survival are directly related to the cause. Clinically, as a practical first step, patients are classified as having either ischemic or non-ischemic cardiomyopathy, a delineation usually based on the presence or absence of epicardial coronary artery disease. However, this approach does not account for patients with non-ischemic cardiomyopathy who also have coronary artery disease, which may be either incidental or partly contributing to myocardial dysfunction (mixed cardiomyopathy). By allowing direct assessment of the myocardium, delayed-enhancement cardiovascular magnetic resonance (DE-CMR) may aid in addressing these conundrums. This article explores the use of DE-CMR in identifying ischemic and non-ischemic myopathic processes and details a systematic approach to determine the cause of cardiomyopathy.
Senthilkumar
Annamalai
A
Duke University Medical Center, Durham, NC 27710, USA.
Majmudar
Maulik D
MD
Shenoy
Chetan
C
Kim
Han W
HW
Kim
Raymond J
RJ
D000465:Algorithms; D009202:Cardiomyopathies / Q000145:classification / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D003324:Coronary Artery Disease / Q000150:complications / Q000175:diagnosis; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D017202:Myocardial Ischemia / Q000150:complications / Q000175:diagnosis