Abstract 15814: The Diagnosis of Cardiomyopathy Using both Late Gadolinium Enhancement and Left Ventricular Mass Index
Introduction: The differentiation of idiopathic dilated cardiomyopathy (DCM), dilated phase of hypertrophic cardiomyopathy (dHCM), cardiac sarcoidosis (CS) and dilated phase of hypertensive heart disease (dHHD) among primary and secondary cardiomyopathies is a diagnostic dilemma due to the lack of sufficient previous medical information in a clinical practice. Since few studies have investigated the LGE pattern of dilated HCM and HHD by cardiovascular magnetic resonance (CMR), we aimed to differentiate the patients with DCM from those with dHCM, CS and dHHD using CMR.
Methods: We studied the consecutive cardiomyopathy patients with 54 DCM, 18 dHCM, 17 CS and 14 dHHD who underwent both CMR and right ventricular EMB. CMR was performed using both late gadolinium enhancement (LGE) and cine imaging to assess ventricular volumes and mass. The whole heart in CMR was divided into 17 segments. Final diagnosis was done using clinical data except CMR.
Results: The LGE positive segments were 5, 11, 10 and 5 in patients with DCM, dHCM, CS and dHHD respectively. Similar LGE patchy patterns with transmural distribution were observed in dHCM or CS patients although LGE tended to be predominantly located in the interventricular septum with junctional area between the right and left ventricles in dHCM patients, and LGE tended to be located in the epicardial layer in CS patients. Similar LGE linear pattern distributed in the middle layer of the interventricular septum was shown in the DCM or dHHD patients. The LV mass index (LVMI) was higher in patients with dHCM or dHHD than those with DCM or CS (84.2±3.4 vs. 113.3±5.0 g/m2, p=0.0001). ROC indicated the high performance to distinguish between the DCM and dHHD patients and between dHCM and CS patients (area under curve=0.79 and 0.77 respectively).
Conclusions: Both LGE pattern and left ventricular mass index provided by cardiovascular magnetic resonance lead a correct diagnosis for the patients with different etiologies of cardiomyopathy.
- © 2012 by American Heart Association, Inc.