Gadolinium Cardiovascular Magnetic Resonance Predicts Reversible Myocardial Dysfunction and Remodeling in Patients With Heart Failure Undergoing β-Blocker Therapy

David Bello, Dipan J. Shah, George M. Farah, Silvia Di Luzio, Michele Parker, Maryl R. Johnson, William G. Cotts, Francis J. Klocke, Robert O. Bonow, Robert M. Judd, Mihai Gheorghiade, Raymond J. Kim

Research output: Contribution to journalArticle

Abstract

Background - In some patients with heart failure, β-blockers can improve left ventricular (LV) function and reduce morbidity and mortality. We hypothesized that gadolinium-enhanced cardiovascular magnetic resonance imaging (CMR) can predict reversible myocardial dysfunction and remodeling in heart failure patients treated with β-blockers. Methods and Results - Forty-five patients with chronic heart failure underwent CMR. Contrast imaging using gadolinium was performed to obtain high-resolution spatial maps of myocardial scarring and viability. Cine imaging was performed to assess LV function and morphology and was repeated in 35 patients after 6 months of β-blockade. Gadolinium CMR demonstrated scarring in 30 of 45 patients (67%). Scarring was found in 100% of patients with ischemic cardiomyopathy (28 of 28) but in only 12% with nonischemic cardiomyopathy (2 of 17). In the 35 patients who were maintained on β-blockers and had a second study, there was an inverse relation between the extent of scarring at baseline and the likelihood of contractile improvement 6 months later (P<0.001). For instance, contractility improved in 56% (674 of 1207) of regions with no scarring but in only 3% with >75% scarring (8 of 232). Multivariate analysis showed that the amount of dysfunctional but viable myocardium by CMR was an independent predictor of the change in ejection fraction (P=0.01), mean wall motion score (P=0.0007), LV end-diastolic volume index (P=0.007), and LV end-systolic volume index (P<0.0001). Conclusions - For heart failure patients treated with β-blockers, gadolinium-enhanced CMR predicts the response in LV function and remodeling.

Original languageEnglish (US)
Pages (from-to)1945-1953
Number of pages9
JournalCirculation
Volume108
Issue number16
DOIs
StatePublished - Oct 21 2003
Externally publishedYes

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Gadolinium
Magnetic Resonance Spectroscopy
Heart Failure
Cicatrix
Magnetic Resonance Imaging
Left Ventricular Function
Therapeutics
Cardiomyopathies
Stroke Volume
Ventricular Remodeling
Myocardium
Multivariate Analysis
Morbidity
Mortality

Keywords

  • Cardiomyopathy
  • Heart failure
  • Magnetic resonance imaging
  • Receptors, adrenergic, beta

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Gadolinium Cardiovascular Magnetic Resonance Predicts Reversible Myocardial Dysfunction and Remodeling in Patients With Heart Failure Undergoing β-Blocker Therapy. / Bello, David; Shah, Dipan J.; Farah, George M.; Di Luzio, Silvia; Parker, Michele; Johnson, Maryl R.; Cotts, William G.; Klocke, Francis J.; Bonow, Robert O.; Judd, Robert M.; Gheorghiade, Mihai; Kim, Raymond J.

In: Circulation, Vol. 108, No. 16, 21.10.2003, p. 1945-1953.

Research output: Contribution to journalArticle

Bello, D, Shah, DJ, Farah, GM, Di Luzio, S, Parker, M, Johnson, MR, Cotts, WG, Klocke, FJ, Bonow, RO, Judd, RM, Gheorghiade, M & Kim, RJ 2003, 'Gadolinium Cardiovascular Magnetic Resonance Predicts Reversible Myocardial Dysfunction and Remodeling in Patients With Heart Failure Undergoing β-Blocker Therapy', Circulation, vol. 108, no. 16, pp. 1945-1953. https://doi.org/10.1161/01.CIR.0000095029.57483.60
Bello, David ; Shah, Dipan J. ; Farah, George M. ; Di Luzio, Silvia ; Parker, Michele ; Johnson, Maryl R. ; Cotts, William G. ; Klocke, Francis J. ; Bonow, Robert O. ; Judd, Robert M. ; Gheorghiade, Mihai ; Kim, Raymond J. / Gadolinium Cardiovascular Magnetic Resonance Predicts Reversible Myocardial Dysfunction and Remodeling in Patients With Heart Failure Undergoing β-Blocker Therapy. In: Circulation. 2003 ; Vol. 108, No. 16. pp. 1945-1953.
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abstract = "Background - In some patients with heart failure, β-blockers can improve left ventricular (LV) function and reduce morbidity and mortality. We hypothesized that gadolinium-enhanced cardiovascular magnetic resonance imaging (CMR) can predict reversible myocardial dysfunction and remodeling in heart failure patients treated with β-blockers. Methods and Results - Forty-five patients with chronic heart failure underwent CMR. Contrast imaging using gadolinium was performed to obtain high-resolution spatial maps of myocardial scarring and viability. Cine imaging was performed to assess LV function and morphology and was repeated in 35 patients after 6 months of β-blockade. Gadolinium CMR demonstrated scarring in 30 of 45 patients (67{\%}). Scarring was found in 100{\%} of patients with ischemic cardiomyopathy (28 of 28) but in only 12{\%} with nonischemic cardiomyopathy (2 of 17). In the 35 patients who were maintained on β-blockers and had a second study, there was an inverse relation between the extent of scarring at baseline and the likelihood of contractile improvement 6 months later (P<0.001). For instance, contractility improved in 56{\%} (674 of 1207) of regions with no scarring but in only 3{\%} with >75{\%} scarring (8 of 232). Multivariate analysis showed that the amount of dysfunctional but viable myocardium by CMR was an independent predictor of the change in ejection fraction (P=0.01), mean wall motion score (P=0.0007), LV end-diastolic volume index (P=0.007), and LV end-systolic volume index (P<0.0001). Conclusions - For heart failure patients treated with β-blockers, gadolinium-enhanced CMR predicts the response in LV function and remodeling.",
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T1 - Gadolinium Cardiovascular Magnetic Resonance Predicts Reversible Myocardial Dysfunction and Remodeling in Patients With Heart Failure Undergoing β-Blocker Therapy

AU - Bello, David

AU - Shah, Dipan J.

AU - Farah, George M.

AU - Di Luzio, Silvia

AU - Parker, Michele

AU - Johnson, Maryl R.

AU - Cotts, William G.

AU - Klocke, Francis J.

AU - Bonow, Robert O.

AU - Judd, Robert M.

AU - Gheorghiade, Mihai

AU - Kim, Raymond J.

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N2 - Background - In some patients with heart failure, β-blockers can improve left ventricular (LV) function and reduce morbidity and mortality. We hypothesized that gadolinium-enhanced cardiovascular magnetic resonance imaging (CMR) can predict reversible myocardial dysfunction and remodeling in heart failure patients treated with β-blockers. Methods and Results - Forty-five patients with chronic heart failure underwent CMR. Contrast imaging using gadolinium was performed to obtain high-resolution spatial maps of myocardial scarring and viability. Cine imaging was performed to assess LV function and morphology and was repeated in 35 patients after 6 months of β-blockade. Gadolinium CMR demonstrated scarring in 30 of 45 patients (67%). Scarring was found in 100% of patients with ischemic cardiomyopathy (28 of 28) but in only 12% with nonischemic cardiomyopathy (2 of 17). In the 35 patients who were maintained on β-blockers and had a second study, there was an inverse relation between the extent of scarring at baseline and the likelihood of contractile improvement 6 months later (P<0.001). For instance, contractility improved in 56% (674 of 1207) of regions with no scarring but in only 3% with >75% scarring (8 of 232). Multivariate analysis showed that the amount of dysfunctional but viable myocardium by CMR was an independent predictor of the change in ejection fraction (P=0.01), mean wall motion score (P=0.0007), LV end-diastolic volume index (P=0.007), and LV end-systolic volume index (P<0.0001). Conclusions - For heart failure patients treated with β-blockers, gadolinium-enhanced CMR predicts the response in LV function and remodeling.

AB - Background - In some patients with heart failure, β-blockers can improve left ventricular (LV) function and reduce morbidity and mortality. We hypothesized that gadolinium-enhanced cardiovascular magnetic resonance imaging (CMR) can predict reversible myocardial dysfunction and remodeling in heart failure patients treated with β-blockers. Methods and Results - Forty-five patients with chronic heart failure underwent CMR. Contrast imaging using gadolinium was performed to obtain high-resolution spatial maps of myocardial scarring and viability. Cine imaging was performed to assess LV function and morphology and was repeated in 35 patients after 6 months of β-blockade. Gadolinium CMR demonstrated scarring in 30 of 45 patients (67%). Scarring was found in 100% of patients with ischemic cardiomyopathy (28 of 28) but in only 12% with nonischemic cardiomyopathy (2 of 17). In the 35 patients who were maintained on β-blockers and had a second study, there was an inverse relation between the extent of scarring at baseline and the likelihood of contractile improvement 6 months later (P<0.001). For instance, contractility improved in 56% (674 of 1207) of regions with no scarring but in only 3% with >75% scarring (8 of 232). Multivariate analysis showed that the amount of dysfunctional but viable myocardium by CMR was an independent predictor of the change in ejection fraction (P=0.01), mean wall motion score (P=0.0007), LV end-diastolic volume index (P=0.007), and LV end-systolic volume index (P<0.0001). Conclusions - For heart failure patients treated with β-blockers, gadolinium-enhanced CMR predicts the response in LV function and remodeling.

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KW - Magnetic resonance imaging

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