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Evaluation of Left Ventricular Structure and Function using 3D Echocardiography
06:34

Evaluation of Left Ventricular Structure and Function using 3D Echocardiography

Published on: October 28, 2020

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[Late gadolinium enhancement distribution pattern of left ventricular wall in patients with dilated cardiomyopathy: a

R Li1, C Cui2, T Lan2

  • 1Department of Magnetic Resonance Imaging, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union, Beijing 100037, China; Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Sichuan Key Laboratory of Medical Imaging, Nanchong 637007, China.

Zhonghua Xin Xue Guan Bing Za Zhi
|November 19, 2020
PubMed

Insights

Late gadolinium enhancement (LGE) patterns in the left ventricular free wall are common in dilated cardiomyopathy (DCM) patients. These patterns correlate with disease severity and heart transplantation rates, offering prognostic insights.

Area of Science:

  • Cardiology
  • Radiology
  • Medical Imaging

Background:

  • Dilated cardiomyopathy (DCM) is a significant cause of heart failure.
  • Late gadolinium enhancement (LGE) on cardiac magnetic resonance (CMR) imaging can reveal myocardial scar tissue.
  • Understanding LGE distribution patterns in DCM is crucial for prognosis.

Purpose of the Study:

  • To investigate the distribution patterns of late gadolinium enhancement (LGE) in the left ventricular free wall of patients with dilated cardiomyopathy (DCM).

Main Methods:

  • Retrospective analysis of 130 DCM patients who underwent CMR and CTA.
  • Detailed assessment of LGE pattern, extent, and distribution in the left ventricular free wall.
  • Correlation of LGE findings with clinical parameters and outcomes, including heart transplantation.

Main Results:

  • LGE was detected in 56% of DCM patients, frequently involving both septal and free walls.
  • Patients with LGE showed higher NYHA class, intraventricular block, ventricular tachycardia, mitral insufficiency, and lower ejection fraction.
  • Subepicardial LGE involved more myocardial segments than intermural or transmural LGE.
  • Transmural LGE predominantly affected inferior lateral and anterior lateral segments.
  • Multiple LGE patterns were associated with a higher percentage of involved myocardial segments.
  • Heart transplantation rates were significantly higher in patients with both septal and free wall LGE.

Conclusions:

  • Distinct LGE distribution patterns exist in the left ventricular free wall of DCM patients.
  • LGE patterns are associated with clinical severity and adverse outcomes.
  • LGE imaging provides valuable prognostic information in DCM.

Keywords:
Cardiomyopathy, dilatedLate gadolinium enhancementMagnetic resonance imaging

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