on October 13, 2003
Published online before print October 13, 2003, doi: 10.1161/01.CIR.0000095029.57483.60
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Submitted on January 9, 2003
From the Feinberg Cardiovascular Research Institute, Division of Cardiology, Northwestern University, Chicago, Ill (D.B., G.M.F., S.D.L., M.R.J., W.G.C., F.J.K., R.O.B., M.G.); and Duke Cardiovascular Magnetic Resonance Center, Division of Cardiology, Duke University, Durham, NC (D.J.S., M.P., R.M.J., R.J.K.). * To whom correspondence should be addressed. E-mail: raymond.kim{at}dcmrc.mc.duke.edu.
Background--In some patients with heart failure, Methods and Results--Forty-five patients with chronic heart failure underwent CMR. Contrast imaging using gadolinium was performed to obtain high-resolution spatial maps of myocardial scarring and viability. Cine imaging was performed to assess LV function and morphology and was repeated in 35 patients after 6 months of Conclusions--For heart failure patients treated with
Revised on July 21, 2003
Accepted on July 21, 2003
Gadolinium Cardiovascular Magnetic Resonance Predicts Reversible Myocardial Dysfunction and Remodeling in Patients With Heart Failure Undergoing
David Bello MD, 
-Blocker Therapy
-blockers can improve left ventricular (LV) function and reduce morbidity and mortality. We hypothesized that gadolinium-enhanced cardiovascular magnetic resonance imaging (CMR) can predict reversible myocardial dysfunction and remodeling in heart failure patients treated with -blockers.-blockade. Gadolinium CMR demonstrated scarring in 30 of 45 patients (67%). Scarring was found in 100% of patients with ischemic cardiomyopathy (28 of 28) but in only 12% with nonischemic cardiomyopathy (2 of 17). In the 35 patients who were maintained on -blockers and had a second study, there was an inverse relation between the extent of scarring at baseline and the likelihood of contractile improvement 6 months later (P<0.001). For instance, contractility improved in 56% (674 of 1207) of regions with no scarring but in only 3% with >75% scarring (8 of 232). Multivariate analysis showed that the amount of dysfunctional but viable myocardium by CMR was an independent predictor of the change in ejection fraction (P=0.01), mean wall motion score (P=0.0007), LV end-diastolic volume index (P=0.007), and LV end-systolic volume index (P
0.0001).-blockers, gadolinium-enhanced CMR predicts the response in LV function and remodeling.
Key words: heart failure • receptors, adrenergic, beta • cardiomyopathy • magnetic resonance imaging
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