Late Gadolinium Enhancement Magnetic Resonance Imaging in the Diagnosis and Prognosis of Endomyocardial Fibrosis Patients

Endocardial fibrous tissue (FT) deposition is a hallmark of endomyocardial fibrosis (EMF). Echocardiography is a first-line and the standard technique for the diagnosis of this disease. Although late gadolinium enhancement (LGE) cardiovascular magnetic resonance (CMR) allows FT characterization, its...

Full description

Saved in:

Bibliographic Details
Published in:	Circulation. Cardiovascular imaging Vol. 4; no. 3; pp. 304 - 311
Main Authors:	SALEMI, Vera M. C, ROCHITTE, Carlos E, MADY, Charles, SHIOZAKI, Afonso A, ANDRADE, Joalbo M, PARGA, Jose R, DE AVILA, Luiz F, BENVENUTI, Luiz A, CESTARI, Ismar N, PICARD, Michael H, KIM, Raymond J
Format:	Journal Article
Language:	English
Published:	Hagerstown, MD Lippincott Williams & Wilkins 01-05-2011
Subjects:	Adult Aged Biological and medical sciences Cardiology. Vascular system Cardiovascular system Contrast Media Endomyocardial Fibrosis - complications Endomyocardial Fibrosis - diagnosis Endomyocardial Fibrosis - pathology Endomyocardial Fibrosis - physiopathology Female Gadolinium DTPA Heart Heart Failure - complications Heart failure, cardiogenic pulmonary edema, cardiac enlargement Heart Ventricles - pathology Humans Image Processing, Computer-Assisted Investigative techniques of hemodynamics Investigative techniques, diagnostic techniques (general aspects) Magnetic Resonance Imaging Magnetic Resonance Imaging, Cine Male Medical sciences Middle Aged Myocarditis. Cardiomyopathies Prognosis Stroke Volume Ultrasonic investigative techniques magnetic resonance imaging Prognosis Volume fraction Disease Restrictive cardiomyopathy Cardiovascular disease Gadolinium Standard Duplex ultrasonography Myocardial disease endomyocardial fibrosis Result Characterization Heart disease Female Tumor Ventricular ejection Diagnosis Woman Age Deposition Sonography Human Heart failure Evaluation Late Echocardiography Magnetic resonance myocardial cardiomyopathy disease Patient Method Nuclear magnetic resonance imaging Standards Fibrous tissue Treatment Fibrosis Medical imagery Hemodynamics Technique Constrictive hypertrophic cardiomyopathy Ejection fraction
Online Access:	Get full text
Tags:	Add Tag No Tags, Be the first to tag this record!

Description
Summary:	Endocardial fibrous tissue (FT) deposition is a hallmark of endomyocardial fibrosis (EMF). Echocardiography is a first-line and the standard technique for the diagnosis of this disease. Although late gadolinium enhancement (LGE) cardiovascular magnetic resonance (CMR) allows FT characterization, its role in the diagnosis and prognosis of EMF has not been investigated. Thirty-six patients (29 women; age, 54±12 years) with EMF diagnosis after clinical evaluation and comprehensive 2-dimensional Doppler echocardiography underwent cine-CMR for assessing ventricular volumes, ejection fraction and mass, and LGE-CMR for FT characterization and quantification. Indexed FT volume (FT/body surface area) was calculated after planimetry of the 8 to 12 slices obtained in the short-axis view at end-diastole (mL/m(2)). Surgical resection of FT was performed in 16 patients. In all patients, areas of LGE were confined to the endocardium, frequently as a continuous streak from the inflow tract extending to the apex, where it was usually most prominent. There was a relation between increased FT/body surface area and worse New York Heart Association functional class and with increased probability of surgery (P<0.05). The histopathologic examination of resected FT showed typical features of EMF with extensive endocardial fibrous thickening, proliferation of small vessels, and scarce inflammatory infiltrate. In multivariate analysis, the patients with FT/body surface area >19 mL/m(2) had an increased mortality rate, with a relative risk of 10.8. Our study provides evidence that LGE-CMR is useful in the diagnosis and prognosis of EMF through quantification of the typical pattern of FT deposition.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1941-9651 1942-0080
DOI:	10.1161/circimaging.110.950675