Late Gadolinium Enhancement Variation in Asymptomatic Individuals: Comparison with Dilated Cardiomyopathy

Area of Science:

• Cardiology
• Radiology
• Medical Imaging

Background:

• Late gadolinium enhancements (LGEs) on cardiac MRI can appear as septal stripes in asymptomatic individuals.
• These findings can mimic abnormal LGEs seen in patients with dilated cardiomyopathy (DCM).

Purpose of the Study:

• To evaluate the frequency and extent of LGE variations in asymptomatic individuals.
• To compare LGE characteristics between asymptomatic individuals and DCM patients.

Main Methods:

• Retrospective analysis of cardiac MRI scans from 273 asymptomatic individuals and 100 DCM patients.
• LGE defined as myocardial signal intensity >5 standard deviations above normal.
• LGE evaluation in right ventricular insertion points (RVIPs) and mid-interventricular septum.

Main Results:

• LGE was observed in 99.3% of asymptomatic individuals and 100% of DCM patients.
• Significant differences in the number of myocardial segments with LGE (5.5 vs. 7.6) and LGE thickness (mid-septum: 4.5mm vs. 5.7mm; RVIPs: 6.1-6.4mm vs. 8.7-8.6mm) between groups (p<0.001).
• Considerable overlap in LGE patterns was noted despite distinct characteristics.

Conclusions:

• Septal stripes are common in asymptomatic individuals and show distinct LGE characteristics compared to DCM.
• Normal LGE findings should not be misinterpreted as pathological in myocardial disease evaluation.