J Med Assoc Thai 2011; 94 (2):33

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Late Gadolinium Enhancement from Cardiac Magnetic Resonance in Ischemic and Non-Ischemic Cardiomyopathy
Krittayaphong R Mail, Boonyasirinant T , Saiviroonporn P , Udompunturak S

Background: Diagnosis of coronary artery disease in patients with heart failure with systolic dysfunction usually requires
coronary angiography. Cardiac magnetic resonance (CMR) is an accurate tool for the assessment of myocardial scar which
may be the major cause of left ventricular systolic dysfunction.

Objective: This study was to determine the prevalence and the difference in pattern of late gadolinium enhancement (LGE)
between patients with ischemic (ICM) and non-ischemic cardiomyopathy (NICM).
Material and Method: We enrolled 98 patients with heart failure and left ventricular systolic dysfunction with left ventricular
ejection fraction less than 50%. All patients underwent CMR. CMR protocol included functional study and assessment of LGE.
Left ventricular volume and ejection fraction was measured. The presence and extent of LGE including its pattern were
assessed.

Results: There were 58 patients with ICM and 40 patients with NICM. Patients with NICM had a lower left ventricular ejection
fraction than those with ICM with a similar left ventricular wall thickness. LGE was detected in 53 patients with ICM (91.5%)
and 10 patients with NICM (25%). LGE pattern was transmural or subendocardial pattern in patients with ICM and midwall
scar in those with NICM.

Conclusion: The presence and pattern of LGE can differentiate systolic heart failure from ICM and NICM.

Keywords: Late gadolinium enhancement, Cardiomyopathy

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