PMID- 16368300
OWN - NLM
STAT- MEDLINE
DCOM- 20060331
LR  - 20151119
IS  - 1097-6744 (Electronic)
IS  - 0002-8703 (Linking)
VI  - 151
IP  - 1
DP  - 2006 Jan
TI  - Identification of the ischemic etiology of heart failure by cardiovascular 
      magnetic resonance imaging: diagnostic accuracy of late gadolinium enhancement.
PG  - 101-8
AB  - BACKGROUND: A large proportion of patients with heart failure (HF) have a large 
      and poorly contracting left ventricle. The noninvasive recognition of the 
      ischemic etiology of such patients is difficult, and for this purpose, usually 
      patients undergo coronary angiography. It has been shown that cardiovascular 
      magnetic resonance (CMR) imaging can detect myocardial scarring by evaluating 
      late gadolinium enhancement (LGE). The diagnostic accuracy of such method in 
      differentiating the etiology of HF has not been previously tested in an 
      unselected HF ambulatory population. METHODS: We studied 60 ambulatory patients 
      consecutively enrolled from a specialized HF clinic. We included HF patients who 
      were found to have increased left ventricular (LV) dimensions and reduced 
      function. CMR was performed in these patients by operators who were unaware of 
      patients' history and clinical conditions. LV dimensions and global and regional 
      function, as well as the pattern of LGE, were obtained in each subject. Coronary 
      angiography was subsequently performed in all the patients. The diagnostic 
      accuracy of clinical history and electrocardiographic patterns, as well as 
      regional wall motion abnormalities, wall thinning, and LGE, in differentiating 
      coronary artery disease (CAD) from non-CAD patients were evaluated. RESULTS: The 
      majority of CAD patients (98%) showed LV contrast hyperenhancement with respect 
      to non-CAD HF subjects (16%). The detection of LGE by CMR had a sensitivity of 
      98% and a specificity of 84% and an overall accuracy of 93% in detecting CAD 
      etiology among HF patients. CONCLUSIONS: LGE is able to accurately differentiate 
      CAD from non-CAD etiology of HF and may represent a clinically useful noninvasive 
      tool for this purpose. As it provides relevant functional information as well as 
      insight into the etiology, CMR may be included among the most important 
      diagnostic tools in the workup of patients with HF.
FAU - Casolo, Giancarlo
AU  - Casolo G
AD  - Department of Cardiology, Azienda Universitaria Ospedaliera Careggi, Florence, 
      Italy. casolo@virgilio.it
FAU - Minneci, Sergio
AU  - Minneci S
FAU - Manta, Rosanna
AU  - Manta R
FAU - Sulla, Antonio
AU  - Sulla A
FAU - Del Meglio, Jacopo
AU  - Del Meglio J
FAU - Rega, Luigi
AU  - Rega L
FAU - Gensini, Gianfranco
AU  - Gensini G
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Am Heart J
JT  - American heart journal
JID - 0370465
RN  - 0 (Contrast Media)
RN  - K2I13DR72L (Gadolinium DTPA)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - *Contrast Media
MH  - Female
MH  - *Gadolinium DTPA
MH  - Heart Failure/*diagnosis/*etiology
MH  - Humans
MH  - *Magnetic Resonance Imaging
MH  - Male
MH  - Middle Aged
MH  - Myocardial Ischemia/*complications
MH  - Reproducibility of Results
EDAT- 2005/12/22 09:00
MHDA- 2006/04/01 09:00
CRDT- 2005/12/22 09:00
PHST- 2004/05/07 00:00 [received]
PHST- 2005/03/10 00:00 [accepted]
PHST- 2005/12/22 09:00 [pubmed]
PHST- 2006/04/01 09:00 [medline]
PHST- 2005/12/22 09:00 [entrez]
AID - S0002-8703(05)00536-3 [pii]
AID - 10.1016/j.ahj.2005.03.068 [doi]
PST - ppublish
SO  - Am Heart J. 2006 Jan;151(1):101-8. doi: 10.1016/j.ahj.2005.03.068.