Endomyocardial fibrosis: a restrictive cardiomyopathy in developing countries

Area of Science:

• Cardiology
• Cardiovascular Imaging
• Restrictive Cardiomyopathy

Background:

• Endomyocardial fibrosis (EF) is an uncommon restrictive cardiomyopathy predominantly found in tropical regions.
• Reports of EF in Latin America are scarce, necessitating further characterization of this condition in the region.

Purpose of the Study:

• To describe the sociodemographic, clinical, and imaging characteristics of patients diagnosed with endomyocardial fibrosis (EF) in Colombia.
• To increase awareness and understanding of EF in a Latin American population.

Main Methods:

• A retrospective review of cardiac magnetic resonance imaging (MRI) records from 2016-2019 was conducted.
• Patients diagnosed with EF were identified, and their sociodemographic, clinical, and imaging data were analyzed.

Main Results:

• Nine patients (66.7% female, average age 69) diagnosed with EF were identified.
• Dyspnea was the most common symptom; echocardiography revealed predominant left ventricular involvement and a restrictive filling pattern.
• Cardiac MRI showed preserved biventricular systolic function and volumes, with focal subendocardial late gadolinium enhancement and apical thrombus in 66% of patients.

Conclusions:

• Endomyocardial fibrosis (EF) is an uncommon restrictive cardiomyopathy with preserved ventricular function in most affected patients.
• The findings highlight the importance of recognizing EF's varied presentations, even when not initially suspected, and underscore the utility of cardiac MRI in diagnosis.