title: Evidence of myocardial edema in patients with nonischemic dilated cardiomyopathy.
abstract: BACKGROUND
  Nonischemic dilated cardiomyopathy (DCM) is associated with high mortality and morbidity. Cardiovascular magnetic resonance allows for the noninvasive assessment of function, morphology, and myocardial edema. Activation of inflammatory pathways may play an important role in the etiology of chronic DCM and may also be involved in the disease progression.
  
  
  OBJECTIVE
  The purpose of our study was to assess the incidence of myocardial edema as a marker for myocardial inflammation in patients with nonischemic DCM.
  
  
  METHODS
  We examined 31 consecutive patients ( mean age, 57 ± 12 years) with idiopathic DCM. Results were compared with 39 controls matched for gender and age (mean age, 53 ± 13 years). Parameters of left ventricular function and volumes, and electrocardiogram-triggered, T2-weighted, fast spin echo triple inversion recovery sequences were applied in all patients and controls. Variables between patients and controls were compared using t tests for quantitative and χ2 tests for categorical variables.
  
  
  RESULTS
  Ejection fraction (EF) was 40.3 ± 7.8% in patients and 62.6 ± 5.0% in controls (P < 0.0001). In T2-weighted images, patients with DCM had a significantly higher normalized global signal intensity ratio compared to controls (2.2 ± 0.6 and 1.8 ± 0.3, respectively, P = 0.0006), consistent with global myocardial edema. There was a significant but moderate negative correlation between signal intensity ratio in T2-weighted images and EF (-0.39, P < 0.001).
  
  
  CONCLUSIONS
  Evidence shows that myocardial edema is associated with idiopathic nonischemic DCM. Further studies are needed to assess the clinical and prognostic impact of these findings.
authors.affiliation: Department of Cardiology and Angiology, Albert Ludwig University of Freiburg, Freiburg, Germany. info@praxis-jeserich.de
authors.forename: Michael
authors.initials: M
authors.lastname: Jeserich
authors.forename: Daniela
authors.initials: D
authors.lastname: Föll
authors.forename: Manfred
authors.initials: M
authors.lastname: Olschewski
authors.forename: Simone
authors.initials: S
authors.lastname: Kimmel
authors.forename: Matthias G
authors.initials: MG
authors.lastname: Friedrich
authors.forename: Christoph
authors.initials: C
authors.lastname: Bode
authors.forename: Annette
authors.initials: A
authors.lastname: Geibel
mesh_terms: D002311:Cardiomyopathy, Dilated / Q000473:pathology*; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D004489:Edema, Cardiac / Q000473:pathology*; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D007249:Inflammation / Q000473:pathology; D019028:Magnetic Resonance Imaging, Cine / Q000295:instrumentation; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology*; D011379:Prognosis; D011446:Prospective Studies; D013223:Statistics as Topic; D013318:Stroke Volume; D016277:Ventricular Function, Left