title: Cardiac magnetic resonance imaging for the diagnosis of endomyocardial fibrosis.
abstract: Endomyocardial fibrosis (EMF) is a common cause of restrictive cardiomyopathy in the tropics and has been underdiagnosed in the past. Sometimes it is difficult to differentiate EMF from other restrictive cardiomyopathies. Cur- rently, echocardiography is used for the initial investigations that might lead to a diagnosis of EMF. In this study, we evaluate the usefulness of cardiac magnetic resonance (CMR) imaging as an alternative noninvasive diagnostic tool. Twenty- eight patients (17 men and 11 women; aged 51.9 +/- 13.5 years), who were diagnosed as having restrictive cardiomyopathy after comprehensive echocardiography, underwent CMR imaging with the standard cardiomyopathy protocol. EMF was diagnosed in seven (25%) of these patients. Five patients with EMF had bi-ventricular involvement and one each had right and left ventricular involvement. Myocardial edema indicating acute inflammation was seen in one (14.3%) patient. Apical thrombus was seen in four (57.1%) cases. Subendocardial delayed enhancement was always present in the involved ventricles. Our results show that CMR imaging with late gadolinium enhancement can clearly detect the common hallmarks of EMF: endocardial fibrous tissue and obliteration of the involved ventricular apex.
authors.forename: Narumol
authors.initials: N
authors.lastname: Chaosuwannakit
authors.forename: Pattarapong
authors.initials: P
authors.lastname: Makarawate
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D003937:Diagnosis, Differential; D004719:Endomyocardial Fibrosis / Q000175:diagnosis* / Q000503:physiopathology; D005260:Female; D005682:Gadolinium; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011868:Radioisotopes; D012189:Retrospective Studies; D013318:Stroke Volume
chemical_list: D011868:Radioisotopes; D005682:Gadolinium