Clinical & Experimental Cardiology
Open Access

Abstract

Clinical and Functional Correlates of Myocardial Fibrosis in Dilated Cardiomyopathy

Michael Jeserich, Matthias G. Friedrich, Manfred Olschewski, Simone Kimmel, Daniela Föll, Christoph Bode and Annette Geibel

Background: The purpose of our study was to investigate the presence of myocardial fibrosis in patients with dilated cardiomyopathy compared to clinical and functional patterns and in comparison to a control cohort.

Methods: We examined 45 consecutive patients with dilated cardiomyopathy and no coronary artery disease (ejection fraction (EF) 38.5±8.9%). Results were compared with 46 controls similarly distributed for age with normal EF (63±5.5%). Late gadolinium enhancement sequences and functional parameters of left ventricular function were obtained.

Results: We observed a significant difference between patients and controls in late gadolinium enhancement, that is, 30 (67 %) of the patients presented subepicardial or midmyocardial lesions of enhancement, whereas only 5 (11%) of the controls did so, (p<0.0001). Stroke volume and cardiac output were significantly lower in patients with lesions, compared to patients without lesions. Patients with lesions had a higher NYHA class. There were significantly more patients than controls with enhancement of the pericardium (47% vs 15%, p =0.001).

Conclusion: In patients with dilated cardiomyopathy, the presence of myocardial lesions correlates with LV functional parameters and clinical markers of heart failure. The regional distribution pattern indicates an important role of remote myocarditis and perimyocarditis in the etiology of this disease.