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This Article Full Text Full Text (PDF) All Versions of this Article: 295/3/H1234    most recent 00429.2008v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Jerosch-Herold, M. Articles by Hershberger, R. E. PubMed PubMed Citation Articles by Jerosch-Herold, M. Articles by Hershberger, R. E.

Cardiac magnetic resonance imaging of myocardial contrast uptake and blood flow in patients affected with idiopathic or familial dilated cardiomyopathy

¹Division of Cardiology, Department of Medicine, and ²Advanced Imaging Research Center, Oregon Health and Science University, Portland, Oregon; and ³Cardiovascular Division, Department of Medicine, University of Miami Miller School of Medicine, Miami, Florida

Submitted 24 April 2008 ; accepted in final form 17 July 2008

Idiopathic dilated cardiomyopathy (IDC) is characterized by left ventricular (LV) enlargement with systolic dysfunction, other causes excluded. When inherited, it represents familial dilated cardiomyopathy (FDC). We hypothesized that IDC or FDC would show with cardiac magnetic resonance (CMR) increased myocardial accumulation of gadolinium contrast at steady state and decreased baseline myocardial blood flow (MBF) due to structural alterations of the extracellular matrix compared with normal myocardium. CMR was performed in nine persons affected with IDC/FDC. Healthy controls came from the general population (n = 6) or were unaffected family members of FDC patients (n = 3) without signs or symptoms of IDC/FDC or any structural cardiac abnormalities. The myocardial partition coefficient for gadolinium contrast (_Gd) was determined by T1 measurements. LV shape and function and MBF were assessed by standard CMR methods. _Gd was elevated in IDC/FDC patients vs. healthy controls (_Gd = 0.56 ± 0.15 vs. 0.41 ± 0.06; P = 0.002), and correlated with LV enlargement (r = 0.61 for _Gd vs. end-diastolic volume indexed by height; P < 0.01) and with ejection fraction (r = –0.80; P < 0.001). The extracellular volume fraction was higher in IDC patients than in healthy controls (0.31 ± 0.05 vs. 0.24 ± 0.03; P = 0.002). Resting MBF was lower in IDC patients (0.64 ± 0.13 vs. 0.91 ± 0.22; P = 0.01) than unaffected controls and correlated with both the partition coefficient (r = –0.57; P = 0.012) and the extracellular volume fraction (r = –0.56; P = 0.019). The expansion of the extracellular space correlated with reduced MBF and ventricular dilation. Expansion of the extracellular matrix may be a key contributor to contractile dysfunction in IDC patients.

idiopathic dilated cardiomyopathy; partition coefficient; myocardial blood flow