title: Cardiac magnetic resonance imaging predicts recovery of left ventricular function in acute onset cardiomyopathy.
abstract: BACKGROUND
  In acute onset cardiomyopathy, acute myocarditis is an important cause, as it is associated with a greater likelihood of recovery of cardiac function and its presence may direct specific therapies. Myocarditis can be detected by cardiac magnetic resonance imaging (CMR); however its diagnostic utility and relation to prognosis in acute onset cardiomyopathy are unknown.
  
  
  METHODS
  We performed CMR on 61 patients with acute onset cardiomyopathy and a left ventricular ejection fraction (LVEF) <55%. CMR included assessment of myocardial function, relative myocardial oedema, myocardial inflammation (using global relative enhancement [GRE] of the myocardium 4 minutes post Gad-DTPA contrast) and necrosis or fibrosis (with late gadolinium enhancement [LGE]). Patients were followed up at six months to evaluate LVEF, morbidity and mortality.
  
  
  RESULTS
  There was a greater improvement in LVEF at follow up in those with myocardial inflammation identified by elevated GRE compared to those without (mean increase 19.2±2.5% vs. 6.7±1.7%, p<0.001). However, the presence of myocardial oedema or LGE alone was not associated with a greater recovery of LVEF (p=NS for both). Myocardial inflammation in patients with a baseline LVEF<35% was also associated with a greater recovery of LVEF (mean increase 21.5±2.9% vs. 9.1±3.0%, p<0.01).
  
  
  CONCLUSIONS
  Myocardial inflammation identified by an elevated GRE predicts recovery of LV function in patients with acute onset cardiomyopathy.
authors: The Alfred Hospital, Melbourne, Victoria, Australia; St Vincent's Hospital, Melbourne, Victoria, Australia.
authors: Alex J A
authors: AJ
authors: McLellan
authors: Scott C
authors: SC
authors: McKenzie
authors: Andrew J
authors: AJ
authors: Taylor
mesh_terms: D000328:Adult; D009202:Cardiomyopathies / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007249:Inflammation / Q000150:complications / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology*; D011237:Predictive Value of Tests; D020127:Recovery of Function; D013318:Stroke Volume; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000503:physiopathology
chemical_list: D003287:Contrast Media; D019786:Gadolinium DTPA