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Delayed enhancement cardiac magnetic resonance imaging reveals typical patterns of myocardial injury in patients with various forms of non-ischemic heart disease

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Abstract

Background Late gadolinium-hyperenhancement (LHE) on cardiac Magnetic Resonance Imaging (CMR) has been linked to cardiovascular risk in ischemic and non-ischemic heart disease. We aimed to systematically categorize LHE-patterns in a variety of non-ischemic heart diseases (NIHD) and to explore their relationship with left ventricular (LV) function. Methods In a retrospective database search, 156 patients with NIHD who exhibited LHE on CMR were identified. All images were re-analyzed stepwise. LHE was correlated to LV functional parameters. Cardiac magnetic resonance (CMR) was conducted on 1.5 T scanners. Results Typically, LHE spared the subendocardium. Consistent LHE-patterns were observed in myocarditis, hypertrophic and dilated cardiomyopathy and systemic vasculitis. No conclusive LHE-patterns were observed in patients with aortic stenosis, arterial hypertension, lupus erythematosus, sarcoidosis, ventricular arrhythmia and in a mixed subgroup of rare NIHDs. There was no significant relationship between LHE and ejection fraction. There was no correlation between enddiastolic volume and LHE in either myocarditis (P = 0.13) or dilated cardiomyopathy (P = 0.62). LHE was unrelated to LV-mass in aortic stenosis (P = 0.13) and hypertrophic cardiomyopathy (P = 0.38). Conclusions Distinct LHE patterns exist in various NIHDs and their visualization may ultimately aid diagnosis. Unlike in ischemic heart disease, the structure-function relationship does not appear to be strong.

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Acknowledgements

We would like to thank our study nurse Melanie Bochmann, as well as our technicians Kerstin Kretschel, Denise Kleindienst, Ursula Wagner, Evelyn Polzien and Franziska Neumann for their assistance.

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Authors and Affiliations

  1. Franz Volhard Clinic, Charité Campus Buch, University Medicine Berlin, HELIOS Clinics Schwanebecker Chaussee 50, 13125, Berlin, Germany

    Steffen Bohl, Ralf Wassmuth, Hassan Abdel-Aty, André Rudolph, Daniel Messroghli, Rainer Dietz & Jeanette Schulz-Menger

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  1. Steffen Bohl
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  2. Ralf Wassmuth
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  3. Hassan Abdel-Aty
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  4. André Rudolph
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  7. Jeanette Schulz-Menger
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Correspondence to Steffen Bohl.

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Steffen Bohl and Ralf Wassmuth—contributed equally to this work.

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Bohl, S., Wassmuth, R., Abdel-Aty, H. et al. Delayed enhancement cardiac magnetic resonance imaging reveals typical patterns of myocardial injury in patients with various forms of non-ischemic heart disease. Int J Cardiovasc Imaging 24, 597–607 (2008). https://doi.org/10.1007/s10554-008-9300-x

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  • DOI: https://doi.org/10.1007/s10554-008-9300-x

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