Role of cardiac MRI in assessment of patients with dilated cardiomyopathy

To study additive role of CMR to echocardiography in assessment of dilated cardiomyopathy and if LGE-CMR myocardial enhancement pattern can differentiate between ischemic and non-ischemic dilated cardiomyopathy compared to coronary catheterization as a reference standard. Eligible 35 patients with dilated cardiomyopathy were involved in our study and included on basis of echocardiographic findings. All patients were subjected to history taking, trans-thoracic echocardiography, diagnostic coronary angiography, and late gadolinium enhanced CMR (LGE CMR). CMR used for assessment of cardiac morphology, function, segmental wall motion abnormalities (SWMA), presence, pattern, and transmularity index of myocardial scars. It was found that CMR capable of detecting myocardial scars and differentiating between ischemic and non-ischemic ones as compared to coronary catheterization data with a highly statistically significant difference (p < 0.001). Good negative correlation (p = 0.002) between grade of transmularity index of detected myocardial scar and LVEF. Strong positive correlation between grade of transmularity index of detected myocardial scar and number of affected myocardial segments by SWMA & LVEDD (p value = <0.001). CMR was capable of studying cardiac morphology, function myocardial viability at the same session, and is more sensitive for assessment of SWMA than echocardiography. LGE-CMR can effectively differentiate between ischemic and non-ischemic dilated cardiomyopathy on basis of myocardial scar enhancement pattern.