Cardiac Magnetic Resonance (CMR) with delayed enhancement (DE) technique allows detection of myocardial scar. Whereas DE is highly sensitive in characterizing myocardial scarring, it is not specific for ischemic damage since gadopentetate dimeglumine generally accumulates in tissue with increased water content. Thus, DE occurs in myocardial areas of fibrosis, inflammation, and edema where the extracellular volume is enlarged. Different myocardial disorders are accompanied by fibrosis or inflammation and might be diagnosed and distinguished from ischemic disease based on the pattern and localization of DE in...

We enrolled 300 patients (67±6 years; 220 male) with the following inclusion criteria: no hystory of CAD; asymptomatic for angor; NYHA class I-II; no hystory of cardiac ospedalization; new diagnosed LV dysfunction (LV ejection fraction <45%) by ambulatory echocardiographic evaluation. All the patients performed a CMR examination. CMR examination was performed with a 1.5T scanner (Signa Excite, GE). Protocol included: LV volumes, mass, ejection fraction and wall motion using with a conventional approach (acquisition of 3 long axis views and 13-15 cine SSFP short axis...

In 166 patient non-ischemic pattern or absence of enhancement was reported and 164 (98.8%) of those showed no CAD. Case 1: Female, 58 years, effort dyspnea (NYHA II) from 3 month, no angina, no history of cardiac and non cardiac disease. On the cine-images is shown a LV dysfunction (Fig. 1), with a non ischemic pattern of DE (Fig. 2) and no-CAD on the coronary angiography (Fig. 3). Post-ischemic pattern was reported in 128 patients, 125 (97.7%) of those presenting CAD. Case 2: male, 53...

In asymptomatic (or poor symptomatic) patients with new diagnosed LV dysfunction and no history of cardiac disease DE-CMR demonstrated very high specificity and sensitivity to predict CAD as main cause of dysfunction. The use of CMR as non invasive, ambulatory imaging technique could be proposed in this cohort of patients. In this way, this technique can be very useful for a better clinical management of patients, showing several advantages as reduce cost, limited the hospitalization, avoid complications of an invasive technique (coronary angiography) in a...

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