Correlation Between Left Ventricular Diastolic Function and Ejection Fraction in Dilated Cardiomyopathy Using Magnetic Resonance Imaging with Late Gadolinium Enhancement

OBJECTIVES: The distribution of left ventricular (LV) fibrosis and the percent fibrosis in patients with dilated cardiomyopathy (DCM) were evaluated using late gadolinium enhanced (LGE) MRI. Then the relation with the LV ejection fraction (EF) and deceleration time (DT), an index of diastolic function obtained using echocardiography, was investigated.

METHODS: LGEMRI at 20 min after intravenous injection of Gd-DTPA (0.15 +/-0.03 mmol/kg) was performed in 17 patients with DCM. The distribution of the LV enhanced area and LGE rate (%) were calculated. EF, as well as E/A ratio and DT were obtained using echocardiography.

RESULTS: LGE was observed in 15 out of 17 patients (88%) and the enhanced region appeared to represent myocardial fibrosis. The LV fibrosis was often found in the intraventricular septum (IVS), but there were no differences in its distribution. The LGE rate (%) had a correlation between cardiac magnetic resonance ejection fraction (CMREF) (Y = 51.7 – 2.1X [R(2) = 0.23, P<0.001]) and DT (Y = 162.2 +12.0X [R(2) = 0.35, P<0.001]).

CONCLUSIONS: The LV fibrosis is often found in the IVS with DCM. A correlation exists between LGE rate (%) to EF on CMR and DT on echocardiography in patients with DCM. 

PMID: 19729860

Posted in Magnetic Resonance Imaging and tagged , .

One Comment

  1. Very interesting paper comparing DT with the degree of persistent myocardial enhancement. The authors’ findings suggest that it is the degree of fibrosis, rather than the degree of hypertrophy that influences myocardial stiffness.

    Few things are noteworthy:
    1. The prevalence of delayed enhancement in this particular cohort of DCM patients was markedly high at 88%.
    2. It would’ve been great if the transmitral flow measurements would’ve been obtained using Venc PC MRI sequences (rather than or in addition) to echo.

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