Review Article

Role of Cardiac Magnetic Resonance in the Evaluation of Dilated Cardiomyopathy: Diagnostic Contribution and Prognostic Significance

Figure 5

Anthracyclines induced dilated cardiomyopathy assessed with cardiac magnetic resonance at symptoms onset ((a), (b)) and eight months after drug suspension ((c), (d)). At clinical presentation, end-diastolic and end-systolic cine steady-state free-precession images show increased left ventricular volumes (EDV: 166 mL; ESV: 106 mL) with a reduced ejection fraction of 36% and a regional wall motion abnormality mostly involving apical segments. After contrast administration (b), patchy subtle areas of inhomogeneous late enhancement predominantly subepicardially distributed are depicted mostly involving the inferior and inferolateral wall of the left ventricle (arrows) and likely representing foci of replacement fibrosis related to the active inflammation associated with the drug’s exposure. At follow-up ((c), (d)) after drug suspension, cine-MR shows significant recovery in global LV function (EDV 151.4 mL; ESV: 77 mL; EF: 49%) with reduced wall thickness (midseptal wall thickness from 13 mm to 10 mm). At late enhancement imaging (d), regional hyperintensity is no longer observed highly suggesting the healing of the process.
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(a)
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(b)
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(c)
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(d)