Learning objectives
We reviewed the MRI findings of cardiac involvement secondary to systemic diseases,
regarding multiple cases found in a series of over 2800 studies conducted in our centre.
Background
The classical classification of cardiomyopathies proposed in 1995 by the World Health Organization (WHO)1,
has been outdated due to greater awareness of cardiomyopathy,
with the support of molecular biology,
in 2006,
the American Heart Association (AHA) and later in 2008,
the European Society of Cardiology (ESC),
established new definitions and classifications of cardiomyopathy,
which has initiated a debate about which of them is the most appropriate.
Imaging findings OR Procedure details
The AHA defines cardiomyopathies as "a heterogeneous group of myocardial diseases associated with impaired mechanical and / or electrical dysfunction,
which usually (but not invariably) exhibit inappropriate ventricular hypertrophy or dilatation,
due to a variety of etiologies that frequently are genetic.Cardiomyopathies are both confined to the heart or as part of generalized systemic disorders,
often leading to cardiac death or progressive heart failure-related disability".2
The ESC has the following definition of cardiomyopathy: "is a myocardial disorder in which the heart muscle is structurally and functionally...
Conclusion
Secondary cardiomyopathies represent a diagnostic challenge,
given the inspecificity of the clinical manifestations and the overlap between the different entities.
Although echocardiography is a suitable technique for the initial approach to cardiomyopathy,
MRI has become a useful technique in the assessment of cardiac function and follow up of patients with heart disease secondary to systemic diseases.
Late enhancement sequences permit,
with an adequate clinical approach to narrow the differential diagnosis,
improve clinical risk stratification and assess the effectiveness of treatments.
References
1.
Richardson P,
McKenna W,
Bristow M et al.
Report of the 1995 World Health Organization/International Society and Federation of Cardiology Task Force on the Definition and Classification of Cardiomyopathies.
Circulation.
1996;93:84-2.
2.
Maron BJ,
Towbin JA,
Thiene G et al.
American Heart Association; Council on Clinical Cardiology,
Heart Failure and Transplantation Committee; Quality of Care and Outcomes Research and Functional Genomics and Translational Biology Interdisciplinary Working Groups; Council on Epidemiology and Prevention.
Contemporary definitions and classification of the cardiomyopathies: an American Heart Association Scientific...