Evaluation of idiopathic dilated cardiomyopathy with cardiac magnetic resonance imaging

Purpose: The present study was aimed to assess the prevalence, location, and patterns of late gadolinium enhancement (LGE) in idiopathic dilated cardiomyopathy (DCM) on cardiac magnetic resonance (CMR) imaging and to correlate the left ventricular (LV) functions obtained by cine CMR with the values obtained by echocardiography. Methods: This was a prospective single-center study covering a 2-year study period. The authors studied the prevalence, location, and patterns of LGE in idiopathic DCM on CMR and correlated the ventricular functions obtained by CMR with those obtained by echocardiography. Results: LGE was seen in 18/40 (45%) and was absent in 22/40 (55%) of patients. With regard to location, septal enhancement was the most common, seen in 8 (20%) followed by free-wall enhancement in 4 (10%) and a concomitant septal and free-wall enhancement in 6 (15%). In terms of pattern, midwall enhancement was observed in 10 (25%), subepicardial in 2 (5%), subendocardial in 4 (10%), and focal and transmural enhancement in 1 each. The maximum correlation for calculation of LV ejection fraction (EF) was obtained between CMR and two-dimensional echocardiography (P = 0.442). Conclusion: CMR is an accurate tool to determine the phenotype of DCM by identifying the presence, location, and pattern of LGE which has a prognostic value and is used to guide management. CMR is the most accurate assessment tool for the calculation of EF and other volumetric variables in DCM.