Cardiac magnetic resonance imaging predicts recovery of left ventricular function in acute onset cardiomyopathy

McLellan, Alex J. A., McKenzie, Scott C. and Taylor, Andrew J. (2012) Cardiac magnetic resonance imaging predicts recovery of left ventricular function in acute onset cardiomyopathy. Heart Lung and Circulation, 21 1: 30-35. doi:10.1016/j.hlc.2011.09.005


Author McLellan, Alex J. A.
McKenzie, Scott C.
Taylor, Andrew J.
Title Cardiac magnetic resonance imaging predicts recovery of left ventricular function in acute onset cardiomyopathy
Journal name Heart Lung and Circulation   Check publisher's open access policy
ISSN 1443-9506
1444-2892
Publication date 2012-01
Year available 2011
Sub-type Article (original research)
DOI 10.1016/j.hlc.2011.09.005
Volume 21
Issue 1
Start page 30
End page 35
Total pages 6
Place of publication Chatswood, NSW, Australia
Publisher Elsevier Australia
Collection year 2012
Language eng
Formatted abstract
Background

In acute onset cardiomyopathy, acute myocarditis is an important cause, as it is associated with a greater likelihood of recovery of cardiac function and its presence may direct specific therapies. Myocarditis can be detected by cardiac magnetic resonance imaging (CMR); however its diagnostic utility and relation to prognosis in acute onset cardiomyopathy are unknown.

Methods


We performed CMR on 61 patients with acute onset cardiomyopathy and a left ventricular ejection fraction (LVEF) <55%. CMR included assessment of myocardial function, relative myocardial oedema, myocardial inflammation (using global relative enhancement [GRE] of the myocardium 4 minutes post Gad-DTPA contrast) and necrosis or fibrosis (with late gadolinium enhancement [LGE]). Patients were followed up at six months to evaluate LVEF, morbidity and mortality.

Results


There was a greater improvement in LVEF at follow up in those with myocardial inflammation identified by elevated GRE compared to those without (mean increase 19.2 ± 2.5% vs. 6.7 ± 1.7%, p < 0.001). However, the presence of myocardial oedema or LGE alone was not associated with a greater recovery of LVEF (p = NS for both). Myocardial inflammation in patients with a baseline LVEF < 35% was also associated with a greater recovery of LVEF (mean increase 21.5 ± 2.9% vs. 9.1 ± 3.0%, p < 0.01).

Conclusion

Myocardial inflammation identified by an elevated GRE predicts recovery of LV function in patients with acute onset cardiomyopathy.

Keyword Myocarditis
Cardiomyopathy
Cardiac magnetic resonance imaging
Prognosis
Ejection fraction
Global relative enhancement
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status Non-UQ
Additional Notes Available online 3 November 2011.

Document type: Journal Article
Sub-type: Article (original research)
Collections: Non HERDC
School of Medicine Publications
 
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Created: Tue, 29 Nov 2011, 09:25:36 EST by Matthew Lamb on behalf of School of Medicine