Utility of Delayed Enhancement Cardiac MRI in Evaluation of Restrictive Cardiomyopathy

Document Type : Original Article


The Departments of Radiology* and Cardiology**, Faculty of Medicine, Cairo University


Abstract Background: Restrictive cardiomyopathy (RCM) is a heterogeneous group of myocardial diseases characterized by non-dilated rigid ventricle, leading to severe diastolic dys-function and restrictive filling. RCM is the least common type of the cardiomyopathies. Itexits in the pediatric and adult age groups and can be either primary or secondary to systematic disorders. The two types show different lines of management and different prognosis. Aim of Study: This study aimed to evaluate the role of delayed enhancement cardiac MR in differentiating the types of RCM and in reaching the diagnosis of secondary RCM. Patients and Methods: A total number of 20 cases with echocardiography showing evidence of diastolic dysfunction and elevated filling pressure were enrolled for delayed-enhancement cardiac MRI examination to confirm the diag-nosis of RCM and establish the etiological diagnosis in secondary cases. Results: CMR allowed accurate assessment of the atrial and ventricular volumes, the ventricular function, and the atrio-ventricular valve regurgitation. Fourteen cases showed LGE in different patterns denoting secondary etiology, the specific cause could be reached in most of cases, while the remaining 6 cases were primary. Conclusion: CMR is an efficient tool confirming the diagnosis of RCM.LGE can differentiate primary from sec-ondary RCM, it can direct the diagnosis to specific subtypes of RCM, depending on the pattern of scar formation and hence determine the prognosis and guide the management.