PMID- 21803756
OWN - NLM
STAT- MEDLINE
DCOM- 20120118
LR  - 20191210
IS  - 1879-0844 (Electronic)
IS  - 1388-9842 (Linking)
VI  - 13
IP  - 9
DP  - 2011 Sep
TI  - Occurrence of late gadolinium enhancement is associated with increased left 
      ventricular wall stress and mass in patients with non-ischaemic dilated 
      cardiomyopathy.
PG  - 937-44
LID - 10.1093/eurjhf/hfr082 [doi]
AB  - AIMS: Occurrence 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 RESULTS: We 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 = 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 = 0.025; 19.6 +/- 9.1 vs. 17.5 +/- 8.2 kPa, P = 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 = 
      0.020) and end-systolic wall stress (41 vs. 24%, P = 0.002). Both normal 
      end-diastolic and end-systolic wall stress had a high negative predictive value 
      for LGE (75 and 76%). CONCLUSIONS: The 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.
FAU - Alter, Peter
AU  - Alter P
AD  - Department of Internal Medicine-Cardiology, Philipps University, Marburg, 
      Germany. alter@staff.uni-marburg.de
FAU - Rupp, Heinz
AU  - Rupp H
FAU - Adams, Philipp
AU  - Adams P
FAU - Stoll, Florian
AU  - Stoll F
FAU - Figiel, Jens H
AU  - Figiel JH
FAU - Klose, Klaus J
AU  - Klose KJ
FAU - Rominger, Marga B
AU  - Rominger MB
FAU - Maisch, Bernhard
AU  - Maisch B
LA  - eng
PT  - Evaluation Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20110728
PL  - England
TA  - Eur J Heart Fail
JT  - European journal of heart failure
JID - 100887595
RN  - 0 (Contrast Media)
RN  - K2I13DR72L (Gadolinium DTPA)
SB  - IM
CIN - Eur J Heart Fail. 2011 Sep;13(9):927-8. PMID: 21807661
MH  - Cardiomyopathy, Dilated/complications/*diagnosis/pathology
MH  - *Contrast Media
MH  - Female
MH  - *Gadolinium DTPA
MH  - Humans
MH  - Hypertrophy, Left Ventricular/complications/*diagnosis/pathology
MH  - *Magnetic Resonance Imaging
MH  - Male
MH  - Middle Aged
MH  - Predictive Value of Tests
MH  - Ventricular Dysfunction, Left/complications/diagnosis/pathology
EDAT- 2011/08/02 06:00
MHDA- 2012/01/19 06:00
CRDT- 2011/08/02 06:00
PHST- 2011/08/02 06:00 [entrez]
PHST- 2011/08/02 06:00 [pubmed]
PHST- 2012/01/19 06:00 [medline]
AID - hfr082 [pii]
AID - 10.1093/eurjhf/hfr082 [doi]
PST - ppublish
SO  - Eur J Heart Fail. 2011 Sep;13(9):937-44. doi: 10.1093/eurjhf/hfr082. Epub 2011 
      Jul 28.