title: Distribution of late gadolinium enhancement in end-stage hypertrophic cardiomyopathy and dilated cardiomyopathy: differential diagnosis and prediction of cardiac outcome.
abstract: BACKGROUND
  The prognostic implications of late gadolinium enhancement (LGE) have been evaluated in ischemic and non-ischemic cardiomyopathies. The present study analyzed LGE distribution in patients with end-stage hypertrophic cardiomyopathy (ES-HCM) and with dilated cardiomyopathy (DCM), and tried to identify high risk patients in DCM.
  
  
  METHODS
  Eleven patients with ES-HCM and 72 with DCM underwent cine- and LGE-cardiac magnetic resonance and ultrasound cardiography. The patient outcome was analyzed retrospectively for 5years of follow-up.
  
  
  RESULTS
  LGE distributed mainly in the inter-ventricular septum, but spread more diffusely into other left ventricular segments in patients with ES-HCM and in a certain part of patients with DCM. Thus, patients with DCM can be divided into three groups according to LGE distribution; no LGE (n=24), localized LGE (localized at septum, n=36), and extensive LGE (spread into other segments, n=12). Reverse remodeling occurred after treatment in patients with no LGE and with localized LGE, but did not in patients with extensive LGE and with ES-HCM. The event-free survival rate for composite outcome (cardiac death, hospitalization for decompensated heart failure or ventricular arrhythmias) was lowest in patients with extensive LGE (92%, 74% and 42% in no LGE, localized LGE, and extensive LGE, p=0.02 vs. no LGE), and was comparable to that in patients with ES-HCM (42%).
  
  
  CONCLUSIONS
  In DCM, patients with extensive LGE showed no functional recovery and the lowest event-free survival rate that were comparable to patients with ES-HCM. The analysis of LGE distribution may be valuable to predict reverse remodeling and to identify high-risk patients.
authors: Division of Cardiology, Internal Medicine III, Hamamatsu University School of Medicine, Hamamatsu, Japan.
authors: Masashi
authors: M
authors: Machii
authors: Division of Cardiology, Internal Medicine III, Hamamatsu University School of Medicine, Hamamatsu, Japan. Electronic address: satoh36@hama-med.ac.jp.
authors: Hiroshi
authors: H
authors: Satoh
authors: Division of Cardiology, Internal Medicine III, Hamamatsu University School of Medicine, Hamamatsu, Japan.
authors: Katsunori
authors: K
authors: Shiraki
authors: Division of Cardiology, Internal Medicine III, Hamamatsu University School of Medicine, Hamamatsu, Japan.
authors: Masao
authors: M
authors: Saotome
authors: Division of Cardiology, Internal Medicine III, Hamamatsu University School of Medicine, Hamamatsu, Japan.
authors: Tsuyoshi
authors: T
authors: Urushida
authors: Division of Cardiology, Internal Medicine III, Hamamatsu University School of Medicine, Hamamatsu, Japan.
authors: Hideki
authors: H
authors: Katoh
authors: Department of Radiology, Hamamatsu University School of Medicine, Hamamatsu, Japan.
authors: Yasuo
authors: Y
authors: Takehara
authors: Department of Radiology, Hamamatsu University School of Medicine, Hamamatsu, Japan.
authors: Harumi
authors: H
authors: Sakahara
authors: Department of Cardiology, Seirei Mikatahara General Hospital, Hamamatsu, Japan.
authors: Hayato
authors: H
authors: Ohtani
authors: Department of Cardiology, Seirei Mikatahara General Hospital, Hamamatsu, Japan.
authors: Yasushi
authors: Y
authors: Wakabayashi
authors: Department of Cardiology, Hamamatsu Red Cross Hospital, Hamamatsu, Japan.
authors: Hiroshi
authors: H
authors: Ukigai
authors: Department of Cardiology, Hamamatsu Red Cross Hospital, Hamamatsu, Japan.
authors: Kei
authors: K
authors: Tawarahara
authors: Division of Cardiology, Internal Medicine III, Hamamatsu University School of Medicine, Hamamatsu, Japan.
authors: Hideharu
authors: H
authors: Hayashi
mesh_terms: D000328:Adult; D000368:Aged; D002311:Cardiomyopathy, Dilated / Q000175:diagnosis / Q000473:pathology*; D002312:Cardiomyopathy, Hypertrophic / Q000175:diagnosis / Q000473:pathology*; D003287:Contrast Media / Q000737:chemistry; D003937:Diagnosis, Differential; D018572:Disease-Free Survival; D015150:Echocardiography, Doppler; D005260:Female; D005500:Follow-Up Studies; D019786:Gadolinium DTPA / Q000737:chemistry*; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology*; D012189:Retrospective Studies; D012306:Risk; D014463:Ultrasonography
chemical_list: D003287:Contrast Media; D019786:Gadolinium DTPA
keywords: Cardiac magnetic resonance; Dilated cardiomyopathy; End-stage hypertrophic cardiomyopathy; Late gadolinium enhancement; Outcomes; Reverse remodeling