Background: Diagnosis of coronary artery disease in patients with heart failure with systolic dysfunction usually requires coronary angiography. Cardiac magnetic resonance (CMR) is an accurate tool for the assessment of myocardial scar which may be the major cause of left ventricular systolic dysfunction.
Objective: This study was to determine the prevalence and the difference in pattern of late gadolinium enhancement (LGE) between patients with ischemic (ICM) and non-ischemic cardiomyopathy (NICM).
Material and method: We enrolled 98 patients with heart failure and left ventricular systolic dysfunction with left ventricular ejection fraction less than 50%. Allpatients underwent CMR. CMR protocol included functional study and assessment of LGE. Left ventricular volume and ejection fraction was measured. The presence and extent of LGE including its pattern were assessed.
Results: There were 58 patients with ICM and 40 patients with NICM. Patients with NICM had a lower left ventricular ejection fraction than those with ICM with a similar left ventricular wall thickness. LGE was detected in 53 patients with ICM (91.5%) and 10 patients with NICM (25%). LGE pattern was transmural or subendocardial pattern in patients with ICM and midwall scar in those with NICM.
Conclusion: The presence and pattern ofLGE can differentiate systolic heart failure from ICM and NICM.