open access

Vol 80, No 3 (2022)
Original article
Published online: 2021-12-20
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Role of cardiac magnetic resonance in heart failure of initially unknown etiology: A 10-year observational study

Natalia Ojrzyńska-Witek1, Magdalena Marczak2, Łukasz Mazurkiewicz1, Joanna Petryka-Mazurkiewicz2, Barbara Miłosz-Wieczorek2, Jacek Grzybowski1, Mateusz Śpiewak2
DOI: 10.33963/KP.a2021.0186
·
Pubmed: 34936084
·
Kardiol Pol 2022;80(3):278-285.
Affiliations
  1. Department of Cardiomyopathy, National Institute of Cardiology, Warszawa, Poland
  2. Magnetic Resonance Unit, National Institute of Cardiology, Warszawa, Poland

open access

Vol 80, No 3 (2022)
Original article
Published online: 2021-12-20

Abstract

Background: The heart failure (HF) population is estimated to be 64.3 million people worldwide and continues to grow. Identifying the underlying cause of HF is crucial for patient management and prognosis.
Aims: We sought to evaluate the role of cardiac magnetic resonance (CMR) imaging to identify the etiology of HF and to evaluate the impact of CMR on diagnosis and patient management.
Methods: We retrospectively reviewed the medical charts of 8630 consecutive patients referred for CMR in a large tertiary center between 2008 and 2017 (10 years). In this study, we only included patients referred for CMR due to HF of unknown etiology whose diagnostic workup had not revealed suspicion of any specific cardiac disease leading to HF. We also analyzed changes in patient management that were guided by the CMR findings, which were defined as changes in treatment and/or the necessity of further tests.
Results: The study sample included 243 patients: 173 (71.2%) patients were male, and the mean (SD) age was 44.0 (15.2) years. All patients underwent contrast-enhanced CMR. Late gadolinium enhancement (LGE) was detected in 74.9% of cases. In 94 patients (38.7%), CMR led to a new diagnosis. In 41 patients (16.9%), patient management was changed by CMR. The latter group comprised patients with coronary artery disease, amyloidosis, valvular disease, and cardiomyopathies other than dilated, namely hypertrophic, restrictive, and left ventricular noncompaction.
Conclusions: Our study strongly suggests that CMR imaging is a valuable tool for determining the etiology of HF and affects patient management.

Abstract

Background: The heart failure (HF) population is estimated to be 64.3 million people worldwide and continues to grow. Identifying the underlying cause of HF is crucial for patient management and prognosis.
Aims: We sought to evaluate the role of cardiac magnetic resonance (CMR) imaging to identify the etiology of HF and to evaluate the impact of CMR on diagnosis and patient management.
Methods: We retrospectively reviewed the medical charts of 8630 consecutive patients referred for CMR in a large tertiary center between 2008 and 2017 (10 years). In this study, we only included patients referred for CMR due to HF of unknown etiology whose diagnostic workup had not revealed suspicion of any specific cardiac disease leading to HF. We also analyzed changes in patient management that were guided by the CMR findings, which were defined as changes in treatment and/or the necessity of further tests.
Results: The study sample included 243 patients: 173 (71.2%) patients were male, and the mean (SD) age was 44.0 (15.2) years. All patients underwent contrast-enhanced CMR. Late gadolinium enhancement (LGE) was detected in 74.9% of cases. In 94 patients (38.7%), CMR led to a new diagnosis. In 41 patients (16.9%), patient management was changed by CMR. The latter group comprised patients with coronary artery disease, amyloidosis, valvular disease, and cardiomyopathies other than dilated, namely hypertrophic, restrictive, and left ventricular noncompaction.
Conclusions: Our study strongly suggests that CMR imaging is a valuable tool for determining the etiology of HF and affects patient management.

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Keywords

cardiac magnetic resonance, heart failure, heart failure of unknown etiology, late gadolinium enhancement

About this article
Title

Role of cardiac magnetic resonance in heart failure of initially unknown etiology: A 10-year observational study

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Vol 80, No 3 (2022)

Article type

Original article

Pages

278-285

Published online

2021-12-20

Page views

621

Article views/downloads

227

DOI

10.33963/KP.a2021.0186

Pubmed

34936084

Bibliographic record

Kardiol Pol 2022;80(3):278-285.

Keywords

cardiac magnetic resonance
heart failure
heart failure of unknown etiology
late gadolinium enhancement

Authors

Natalia Ojrzyńska-Witek
Magdalena Marczak
Łukasz Mazurkiewicz
Joanna Petryka-Mazurkiewicz
Barbara Miłosz-Wieczorek
Jacek Grzybowski
Mateusz Śpiewak

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