Clinical Use of Coronary Angiography and Magnetic Nuclear Resonance Imaging in the Diagnosis of Ischemic Cardiomyopathy

Eduardo França Pessoa de Melo, Renata Ávila Cintra, Bruno Biselli, Rodrigo Morel Vieira de Melo, Henrique Barbosa Ribeiro, Luis Francisco Ávila, Pedro Alves Lemos Neto, Expedito E. Ribeiro, Edimar Alcides Bocchi, Germano Emilio Conceição Souza
2013 Revista Brasileira de Cardiologia Invasiva (English Edition)  
The diagnosis of ischemic cardiomyopathy is frequently difficult. Coronary angiography (CA) is limited because it is invasive and the evaluation is exclusively anatomic. Cardiac magnetic resonance imaging (MRI) with late gadolinium enhancement (LGE) measures patterns of myocardial fibrosis caused by ischemia. However, LGE does not detect ischemia that does not result in fibrosis. Thus, a thorough clinical evaluation by a cardiologist seems to be the most effective option for diagnosis. The aim
more » ... diagnosis. The aim of this study was to evaluate CA and LGE as complementary methods for the diagnosis of ischemic cardiomyopathy in patients with systolic heart failure of unknown etiology. Methods: Patients with systolic heart failure, left ventricle ejection fraction < 45% and unknown etiology after initial non-invasive evaluation were submitted to CA and MRI with LGE to define the etiology of the disease. Patient evaluation by two cardiologists was the gold standard for the diagnosis of ischemic cardiomyopathy. Results: Twentyfour patients were included. The sensitivity to detect ischemic cardiomyopathy was 0.45 for CA vs. 0.81 for LGE. The specificity was 1.0 for CA vs. 0.84 for LGE. The positive predictive value was 1.0 vs. 0.81 and the negative predictive value was 0.68 vs. 0.84 for CA and LGE, respectively. LGE accuracy
doi:10.1016/s2214-1235(15)30144-7 fatcat:7ilssaob55ffxbi2mb5jfp35pm