New insights into peripartum cardiomyopathy using cardiac magnetic resonance imaging

Item Type:	Article
Title:	New insights into peripartum cardiomyopathy using cardiac magnetic resonance imaging
Creators Name:	Renz, D.M. and Roettgen, R. and Habedank, D. and Wagner, M. and Boettcher, J. and Pfeil, A. and Dietz, R. and Kivelitz, D. and Elgeti, T.
Abstract:	PURPOSE: The aim of this study was to evaluate a comprehensive cardiac magnetic resonance (MR) imaging approach in patients with peripartum cardiomyopathy (PPCM). The focus was on inflammatory myocardial changes. MATERIALS AND METHODS: Retrospective analysis of 12 cardiac MR examinations was performed in 6 patients with PPCM. The protocol comprised cine sequences for the determination of chamber sizes and function. T 2-weighted sequences for determination of edema (T 2 ratio), T 1-weighted images for measurement of early gadolinium enhancement ratio (EGER), and late gadolinium enhancement (LGE) sequences were used for tissue characterization. 5 examinations were performed during the acute stage, and 7 examinations were performed during the course of the disease. RESULTS: Initially, 3 of 5 patients presented with an elevated left ventricular end-diastolic volume (LVEDV); in one patient, the LVEDV was in the upper range. In 4 of 5 subjects, the left ventricular ejection fraction (LVEF) was decreased. The T 2 ratio and EGER values were initially elevated in all women. No LGE was detected in initial scans. In follow-up examinations, the LVEDV decreased and the LVEF increased in all patients. Tissue-characterizing parameters decreased to normal in all but 1 patient. 2 patients showing LGE did not present a favorable clinical course. CONCLUSION: Myocardial inflammation was detected in the acute stage of PPCM, which was mostly transient. In our small group, patients showing LGE had a non-favorable clinical course. Future studies should include tissue-characterizing parameters, such as T 2 ratio and EGER. Thus, further insights into pathophysiology can be gained and therapeutic effects can be measured in a more extensive manner.
Keywords:	Heart, Peripartum Cardiomyopathy, Tissue Characterization, MR Imaging
Source:	RoeFo Fortschritte auf dem Gebiete der Roentgenstrahlen und der neuen bildgebenden Verfahren
ISSN:	1438-9029
Publisher:	Thieme
Volume:	183
Number:	9
Page Range:	834-841
Date:	September 2011
Official Publication:	https://doi.org/10.1055/s-0031-1281600
PubMed:	View item in PubMed

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