title: Cardiac magnetic resonance imaging in peripartum cardiomyopathy.
abstract: BACKGROUND
  Peripartum cardiomyopathy (PPCM) is a rare life-threatening condition of unclear etiology. Data on the use of cardiac magnetic resonance (CMR) imaging to characterize PPCM are limited. This study was done to assess the role of CMR imaging for the diagnosis and prognostication of patients with PPCM.
  
  
  METHODS
  Medical records of a tertiary medical center were screened for PPCM patients with CMR imaging done within the past 5 years (2006-2011). Images were reviewed by 2 expert radiologists (blinded to clinical data) using cine sequences for chamber function and size, T2-weighted images for the determination of edema (T2-ratio), and late gadolinium enhancement (LGE) sequences for myocardial tissue characterization.
  
  
  RESULTS
  Ten PPCM patients (aged 28 ± 6 years, 90% African American) had a total of 15 CMR examinations: 4 in the acute phase (within 7 days of diagnosis) and 11 during follow-up (median, 12 months; range, 1-72 months). Left ventricular ejection fraction was decreased in all 4 initial scans. Elevated T2 ratio (>2) seen in 1 patient decreased on follow-up imaging. LGE was seen in 1 of the 4 acute-phase scans and in 4 of the 11 follow-up phase scans. These 4 patients had multiple readmissions because of heart failure exacerbations and persistently low left ventricular ejection fraction on subsequent echocardiograms.
  
  
  CONCLUSIONS
  LGE seems to be associated with a poor prognosis in the setting of PPCM. CMR imaging seems to have promising practical implications in the diagnosis and prognostication of PPCM patients.
authors.affiliation: Division of Cardiology, Department of Internal Medicine (NPA, NM, TM, AK, LCA), Wayne State University School of Medicine, Detroit Medical Center, Detroit, Michigan; and Department of Radiology (RD, TL), Wayne State University School of Medicine, Detroit Medical Center, Detroit, Michigan.
authors.forename: Natasha Purai
authors.initials: NP
authors.lastname: Arora
authors.forename: Tamam
authors.initials: T
authors.lastname: Mohamad
authors.forename: Nitin
authors.initials: N
authors.lastname: Mahajan
authors.forename: Raman
authors.initials: R
authors.lastname: Danrad
authors.forename: Anupama
authors.initials: A
authors.lastname: Kottam
authors.forename: Tao
authors.initials: T
authors.lastname: Li
authors.forename: Luis C
authors.initials: LC
authors.lastname: Afonso
mesh_terms: D000293:Adolescent; D000328:Adult; D009202:Cardiomyopathies / Q000175:diagnosis* / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D058725:Peripartum Period; D011247:Pregnancy; D011859:Radiography; D012189:Retrospective Studies; D055815:Young Adult