Keywords:
Cardiac, MR, Diagnostic procedure, Ischaemia / Infarction
Authors:
C. Tudisca1, G. Aquaro2, E. Oddo3, E. Grassedonio3, M. Lombardi2, M. Midiri3; 1Palermo, PA/IT, 2Pisa/IT, 3Palermo/IT
DOI:
10.1594/ecr2013/C-1573
Purpose
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 contrast-enhanced CMR.
Normally ischemic pattern of DE:
- have an involvement of the subendocardial,
- can have a transmural extent,
- can appear as a confluet scar,
- is located in the territory of vascularization of a coronary artery.
Conversely the non ischemic pattern of DE:
- it is characterized by an epicardial involvement,
or by a patchy pattern or an intramural pattern;
- in each case there is not any correlation with the territory of vascularization of one coronary artery.
To date the role of DE-CMR in patients with new-onset left ventricular (LV) dysfunction is not fully evaluated.
The few studies about this topic are retrospective and with a small cohort of patients.
So the aim of the present prospective study was to evaluate the accuracy of CMR to predict coronary artery disease (CAD) as the cause of new diagnosed LV dysfunction in asymptomatic or poor-symptomatic ambulatory patients.