Late gadolinium enhancement in cardiomyopathy

Alpendurada, Francisco; Pennell, Dudley J.

doi:10.1007/s10554-008-9316-2

Cited by 3 publications

(1 citation statement)

References 17 publications

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“…Late gadolinium enhancement has been found in infarcted areas in ischaemic heart disease due to fibrotic remodelling 4–7. Its role in non‐ischaemic cardiomyopathy remains controversial 8–10. Various myocardial injuries such as inflammation and storage diseases are thought to be linked to LGE 11.…”

Section: Introductionmentioning

confidence: 99%

Occurrence of late gadolinium enhancement is associated with increased left ventricular wall stress and mass in patients with non‐ischaemic dilated cardiomyopathy

Alter

Rupp

Adams

et al. 2011

European J of Heart Fail

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AimsOccurrence of late gadolinium enhancement (LGE) as assessed by cardiac magnetic resonance (CMR) imaging has been attributed to various myocardial injuries. We hypothesized that LGE is associated with left ventricular (LV) wall stress. Methods and resultsWe examined 300 patients with suspected non-ischaemic dilated cardiomyopathy. Cardiac magnetic resonance was used to assess LV volume, mass, wall stress, and LGE. Increased LV end-diastolic wall stress (. 4 kPa) was found in 112 patients (37 %), and increased end-systolic wall stress (.18 kPa) in 121 patients (40%). Presence of LGE was observed in 93 patients (31%). End-diastolic (94 + 43 vs. 79 + 42 ml/m 2 , P ¼ 0.006) and end-systolic LV volumes (62 + 44 vs. 44 + 37 ml/m 2 , P , 0.001) and LV mass (95 + 34 vs. 78 + 31 g/m 2 , P , 0.001) were increased in patients exhibiting LGE. In particular, LV end-diastolic and end-systolic wall stress were increased (4.5 + 2.8 vs. 3.6 + 3.0 kPa, P ¼ 0.025; 19.6 + 9.1 vs. 17.5 + 8.2 kPa, P ¼ 0.045). Late gadolinium enhancement was observed more frequently than would be expected from random occurrence in patients with increased end-diastolic (39 vs. 26%, P ¼ 0.020) and end-systolic wall stress (41 vs. 24%, P ¼ 0.002). Both normal end-diastolic and end-systolic wall stress had a high negative predictive value for LGE (75 and 76%). ConclusionsThe present study shows that occurrence of LGE in cardiomyopathy is associated with increased LV wall stress and mass. Suspected causes are an increased capillary leakage by stretch, impaired contrast agent redistribution, or increased diffusion distances. It is proposed that LGE should be considered as a potential prognostic determinant of heart failure and severe arrhythmias.--

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Section: Introductionmentioning

confidence: 99%

Occurrence of late gadolinium enhancement is associated with increased left ventricular wall stress and mass in patients with non‐ischaemic dilated cardiomyopathy

Alter

Rupp

Adams

et al. 2011

European J of Heart Fail

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Non-linear blending of dual-energy CT data improves depiction of late iodine enhancement in chronic myocardial infarction

Wichmann

Kerl

et al. 2014

Int J Cardiovasc Imaging

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To compare non-linear and linear blending of cardiac dual-energy computed tomography (DECT) for optimal visualization of late iodine enhancement (LIE) in patients with chronic myocardial infarction (CMI). LIE-DECT data from 20 patients with known CMI were retrospectively analyzed. Images were reconstructed using non-linear blending center and width settings in the range of 0-500. Linear blending was performed with weighting factors 0.8 (80% 100 kV, 20% 140 kV), 0.6 and 0.3. 100-/140-kV data and blended images were analyzed. Contrast and percentage signal differences between infarcted and healthy myocardium and the left ventricle blood pool were computed. Statistical analysis was performed using repeated-measures analysis of variance and post hoc t tests. Non-linear blending showed the highest signal differences for all contrasts and analyses. Repeated-measures ANOVA tests confirmed the statistical differences between the investigated blending techniques (P < 0.01). Paired-samples post hoc t tests confirmed the significance of these results (P < 0.04). The ideal non-linear blending settings for best demarcation of CMI from healthy myocardium were a center of 65.8 ± 23.2 and a width of 0.0 ± 0.0. Non-linear blending of LIE-DECT improves display of LIE in patients with CMI in comparison with linear blending and non-post-processed image data from 100-/140-kV.

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MR, CT, and PET imaging in pericardial disease

et al. 2012

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Although echocardiography remains the standard diagnostic tool for identifying pericardial diseases, procedures with better delineation of morphology and heart function are often required. The pericardium consists of an inner visceral (epicardium) and outer parietal layer (pericardium), which constitute for the pericardial cavity. Pericardial effusion can occur as transudate, exudate, pyopneumopericardium, or hemopericardium. Potential causes are inflammatory processes, that is, pericarditis due to autoimmune or infective reasons, neoplasms, irradiation, or systemic disorders, chronic renal failure, endocrine, or metabolic diseases. Pericardial fat can mimic pericardial effusion. Using various image-acquisition sequences, MRI allows identifying and separating fluid and solid structures. Fast spin-echo T1-weighted sequences with black-blood preparation are favourably used for morphological evaluation. Fast spin-echo T2-weighted sequences, particularly with fat saturation, and short-tau inversion-recovery sequences are useful to visualize oedema and inflammation. For further tissue characterization, delayed inversion-recovery imaging is used. Therefore, image acquisition is performed at 5-20 min subsequent to contrast agent administration, the so-called technique of late gadolinium enhancement. Ventricular volumes and myocardial mass can be assessed accurately by steady-state free-precession sequences, which is required to measure cardiac function and ventricular wall stress. Constrictive pericarditis usually results from chronic inflammatory processes leading to increased stiffness, which impedes the slippage of both pericardial layers and thereby the normal cardiac filling. CT imaging can favourably assess pericardial calcification. Thus, MR and CT imaging allow a comprehensive delineation of the pericardium. Superior to echocardiography, both methods provide a larger field of view and depiction of the complete chest including abnormalities of the surrounding mediastinum and lungs. PET provides unique information on the in vivo metabolism of 18-fluorodeoxyglucose that can be superimposed on CT findings and is useful for identifying inflammatory processes or masses, for example neoplasms. These imaging techniques provide advanced information of anatomy and cardiac function to optimize the pericardial access, for example by the AttachLifter system, for diagnosis and treatment.

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Late gadolinium enhancement in cardiomyopathy

Cited by 3 publications

References 17 publications

Occurrence of late gadolinium enhancement is associated with increased left ventricular wall stress and mass in patients with non‐ischaemic dilated cardiomyopathy

Occurrence of late gadolinium enhancement is associated with increased left ventricular wall stress and mass in patients with non‐ischaemic dilated cardiomyopathy

Non-linear blending of dual-energy CT data improves depiction of late iodine enhancement in chronic myocardial infarction

MR, CT, and PET imaging in pericardial disease

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