| Article ID | Journal | Published Year | Pages | File Type |
|---|---|---|---|---|
| 2910632 | The Egyptian Heart Journal | 2012 | 5 Pages |
IntroductionCardiovascular magnetic resonance (CMR) with delayed contrast enhancement (DCE) has been recently emerged as an easy-to-perform method for differentiation between normal and diseased myocardium. The aim of this study was to delineate the etiology of chronic heart failure (CHF) non-invasively using DCE-CMR at 3.0 Tesla.MethodsThirty-four patients with CHF, left ventricular ejection fraction (LVEF) <40%, and no clear history or objective evidence of coronary artery disease (CAD) were evaluated by contrast-enhanced CMR (Philips Achiva 3.0 T) and conventional coronary angiography. Significant CAD was defined as >50% diameter stenosis of major epicardial coronary vessel.ResultsFifteen patients showed subendocardial and/or transmural pattern of DCE (group A). Nineteen patients showed pattern of mid wall and/or subepicardial or no DCE (group B). Group A patients were older (52 ± 9 vs. 45 ± 10 years, p = 0.042), had higher prevalence of diabetes mellitus, hypertension and dyslipidemia, p = 0.001. LVEF was comparable in both groups. Coronary angiography showed significant CAD in 14/15 patients in group A. The other patient had coronary artery ectasia of the left anterior descending coronary artery. Normal angiogram was seen in 18/19 patients in group B. The other patient had 60% diameter stenosis of mid dominant right coronary artery. The sensitivity and specificity of DCE-CMR for detection of CAD were 93.3% and 94.7% respectively. The positive likelihood ratio was 17.74.ConclusionPattern of DCE-CMR at 3.0 Tesla may help delineation of etiology of CHF and makes clear distinction between ischemic and non-ischemic pathomorphology.
