Abstract
Dilated Cardiomyopathy is a high-incident disease, which diagnosis of and treatments are clinical priority. The aim of our study was to evaluate the diagnostic potential of cardiac magnetic resonance (CMR) imaging; echocardiography and the biochemical parameters that can help us differentiate between the post-ischemic and non-ischemic dilated cardiomyopathy. Materials and methods. The study enrolled 134 patients with dilated cardiomyopathy: 74 with the post-ischemic form and 60 with the non-ischemic one. All patients underwent a coronary imaging test, with echocardiogram, cardiac magnetic resonance and a blood test. Pro-inflammatory cytokines were evaluated using Luminex kit. Data was compared between the two groups. Results. Echocardiography allowed recognition of Left Ventricular Non Compaction in 2 patients. Longitudinal and circumferential strains were significantly different in the two groups (p<0.05). Using CMR imaging a post-myocarditis scar was diagnosed in 2 patients and a post-ischemic scar in 95% of patients with the chronic ischemic disease. The interleukin IL-1, IL-6 and TNF-α levels were higher in the post-ischemic group compared with the non-ischemic one. Conclusions. The use of second level techniques with a high sensitivity and specificity would help distinguish among different sub-forms of dilated cardiomyopathy.
[1] Maron BJ, Towbin JA, Thiene G, et al. Contemporary definitions and classification of the cardiomyopathies: an American Heart Association Scientific Statement from the Council on Clinical Cardiology, Heart Failure and Transplantation Committee; Quality of Care and Outcomes Research and Functional Genomics and Translational Biology Interdisciplinary Working Groups; and Council on Epidemiology and Prevention. Circulation 2006; 113: 1807–1816 http://dx.doi.org/10.1161/CIRCULATIONAHA.106.17428710.1161/CIRCULATIONAHA.106.174287Search in Google Scholar
[2] Thygesen K, Alpert JS, Jaff AS et al. Third universal definition of myocardial infarction. Circulation. 2012; 126: 2020–2035 http://dx.doi.org/10.1161/CIR.0b013e31826e105810.1161/CIR.0b013e31826e1058Search in Google Scholar
[3] Fatkin D; members of the CSANZ Cardiac Genetic Diseases Council Writing Group. Guidelines for the diagnosis and management of familial dilated cardiomyopathy. Heart Lung Circ. 2011; 20:691–693 http://dx.doi.org/10.1016/j.hlc.2011.07.00810.1016/j.hlc.2011.07.008Search in Google Scholar
[4] Novo S, Akashi Y, Arbustini, Assennato P, Azzarelli S, Barbaro G, Fazio G, Fedele F, Giordan M, Mazzarotto P, Modena MG, Novo G, Parodi G, Rapezzi C, Sconci F, Sganzerla P, Tona F, Salerno-Uriarte JA. Takotsubo Cardiomyopathy: a Consensus document. G Ital Cardiol (Rome), 2008; 9: 785–797 Search in Google Scholar
[5] Sliwa K, Hilfiker-Kleiner D, Petrie MC, et al. Current state of knowledge on aetiology, diagnosis, management, and therapy of peripartum cardiomyopathy: a position statement from the Heart Failure Association of the European Society of Cardiology Working Group on peripartum cardiomyopathy. Eur J Heart Fail 2010; 12:767 http://dx.doi.org/10.1093/eurjhf/hfq12010.1093/eurjhf/hfq120Search in Google Scholar
[6] Manolio TA, Baughman KL, Rodeheffer R et al. Prevalence and etiology of idiopathic dilated cardiomyopathy (summary of a National Heart, Lung and Blood Institute Workshop). Am J Cardiol 1992; 69: 1459–1466 10.1016/0002-9149(92)90901-ASearch in Google Scholar
[7] Mancia G, De Backer G, Dominiczak A et al 2007 Guidelines for the management of arterial hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Eur Heart J. 2007; 28:1462–1536 10.1097/HJH.0b013e3281fc975aSearch in Google Scholar
[8] Jellinger PS, Smith DA, Mehta AE, et al American Association of Clinical Endocrinologists’ Guidelines for Management of Dyslipidemia and Prevention of Atherosclerosis. Endocr Pract. 2012 Mar–Apr; 18Suppl 1:1–78 http://dx.doi.org/10.4158/EP.18.S1.110.4158/EP.18.S1.1Search in Google Scholar
[9] Rydén L, Standl E, Bartnik M et al Guidelines on diabetes, pre-diabetes, and cardiovascular diseases: executive summary. The Task Force on Diabetes and Cardiovascular Diseases of the European Society of Cardiology (ESC) and of the European Association for the Study of Diabetes (EASD). Eur Heart J. 2007; 28:88–136 http://dx.doi.org/10.1093/eurheartj/ehm12410.1093/eurheartj/ehm124Search in Google Scholar
[10] WHO Expert Consultation. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet. 2004 10; 363:157–163 10.1016/S0140-6736(03)15268-3Search in Google Scholar
[11] Task Force on the management of ST-segment elevation acute myocardial infarction of the European Society of Cardiology (ESC), Steg PG, James SK, Atar D, Badano LP, Blömstrom-Lundqvist C, Borger MA, Di Mario C, Dickstein K, Ducrocq G, Fernandez-Aviles F, Gershlick AH, Giannuzzi P, Halvorsen S, Huber K, Juni P, Kastrati A, Knuuti J, Lenzen MJ, Mahaffey KW, Valgimigli M, van’ t Hof A, Widimsky P, Zahger D. ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation. Eur Heart J. 2012 Oct; 33(20):2569–2619 http://dx.doi.org/10.1093/eurheartj/ehs21510.1093/eurheartj/ehs215Search in Google Scholar PubMed
[12] Thygesen K, Alpert JS, Jaffe AS, Simoons ML, Chaitman BR, White HD; Joint ESC/ACCF/AHA/WHF Task Force for the Universal Definition of Myocardial Third universal definition of myocardial infarction. Eur Heart J. 2012 Oct; 33(20):2551–2567 http://dx.doi.org/10.1093/eurheartj/ehs18410.1093/eurheartj/ehs184Search in Google Scholar PubMed
[13] La Grutta L, Runza G, Gentile G, Russo E, Lo Re G, Galia M, Bartolotta TV, Alaimo V, Malagò R, Cademartiri F, Cardinale AE, Midiri M. Prognostic outcome of routine clinical noninvasive multidetector-row computed tomography coronary angiography in patients with suspected coronary artery disease: a 2-year follow-up study. Radiol Med. 2011 Jun; 116(4):521–531 http://dx.doi.org/10.1007/s11547-011-0655-z10.1007/s11547-011-0655-zSearch in Google Scholar PubMed
[14] Stirrat J, White JA. The prognostic role of late gadolinium enhancement magnetic resonance imaging in patients with cardiomyopathy. Can J Cardiol. 2013; 29:329–336 http://dx.doi.org/10.1016/j.cjca.2012.11.03310.1016/j.cjca.2012.11.033Search in Google Scholar PubMed
[15] Giesbrandt KJ, Bolan CW, Shapiro BP, Edwards WD, Mergo PJ. Diffuse diseases of the myocardium: MRI-pathologic review of cardiomyopathies with dilatation. AJR Am J Roentgenol. 2013; 200:W274–W282 http://dx.doi.org/10.2214/AJR.12.963410.2214/AJR.12.9634Search in Google Scholar PubMed
[16] Fazio G, Visconti C, D’angelo L, Grassedonio E, Lo Re G, D’Amico T, Sutera L, Novo G, Ferrara F, Midiri M, Novo S. Diagnosis and definition of biventricular non-compaction associated to Ebstein’s anomaly. Int J Cardiol. 2011; 150:e20–e24 http://dx.doi.org/10.1016/j.ijcard.2009.07.03610.1016/j.ijcard.2009.07.036Search in Google Scholar PubMed
[17] Gulati A, Ismail TF, Jabbour A, Ismail NA, Morarji K, Ali A, Raza S, Khwaja J, Brown TD, Liodakis E, Baksi AJ, Shakur R, Guha K, Roughton M, Wage R, Cook SA, Alpendurada F, Assomull RG, Mohiaddin RH, Cowie MR, Pennell DJ, Prasad SK. Clinical utility and prognostic value of left atrial volume assessment by cardiovascular magnetic resonance in non-ischaemic dilated cardiomyopathy. Eur J Heart Fail. 2013 Jun; 15(6):660–670 http://dx.doi.org/10.1093/eurjhf/hft01910.1093/eurjhf/hft019Search in Google Scholar PubMed
[18] Athanasiadis A, Schneider B, Sechtem U. Role of cardiovascular magnetic resonance in takotsubo cardiomyopathy. Heart Fail Clin. 2013; 9:167–176 http://dx.doi.org/10.1016/j.hfc.2012.12.01110.1016/j.hfc.2012.12.011Search in Google Scholar PubMed
[19] Grothoff M, Pachowsky M, Hoffmann J, Posch M, Klaassen S, Lehmkuhl L, Gutberlet M. Value of cardiovascular MR in diagnosing left ventricular noncompaction cardiomyopathy and in discriminating between other cardiomyopathies. Eur Radiol. 2012;22:2699–2709 http://dx.doi.org/10.1007/s00330-012-2554-710.1007/s00330-012-2554-7Search in Google Scholar PubMed PubMed Central
[20] Koenig W, Khuseyinova N Biomarkers of atherosclerotic plaque instability and rupture. Arterioscler Thromb Vasc Biol 2007; 27:15–26 http://dx.doi.org/10.1161/01.ATV.0000251503.35795.4f10.1161/01.ATV.0000251503.35795.4fSearch in Google Scholar PubMed
[21] Khan DA, Ansari WM, Khan FA Pro/anti-inflammatory cytokines in the pathogenesis of premature coronary artery disease. J Interferon Cytokine Res. 2011 Jul;31(7):561–567 http://dx.doi.org/10.1089/jir.2010.015710.1089/jir.2010.0157Search in Google Scholar PubMed
[22] Rothenbacher D, Kleiner A, Koenig W, Primatesta P, Breitling LP, Brenner H. Relationship between inflammatory cytokines and uric acid levels with adverse cardiovascular outcomes in patients with stable coronary heart disease. PLoS One. 2012;7(9):e45907 http://dx.doi.org/10.1371/journal.pone.004590710.1371/journal.pone.0045907Search in Google Scholar PubMed PubMed Central
[23] Shibasaki I, Nishikimi T, Mochizuki Y, Yamada Y, Yoshitatsu M, Inoue Y, Kuwata T, Ogawa H, Tsuchiya G, Ishimitsu T, Fukuda H. Greater expression of inflammatory cytokines, adrenomedullin, and natriuretic peptide receptor-C in epicardial adipose tissue in coronary artery disease. Regul Pept. 2010 Dec 10;165(2–3):210–217 http://dx.doi.org/10.1016/j.regpep.2010.07.16910.1016/j.regpep.2010.07.169Search in Google Scholar PubMed
[24] Ikonomidis I, Michalakeas CA, Parissis J, Paraskevaidis I, Ntai K, Papadakis I, Anastasiou-Nana M, Lekakis J. Inflammatory markers in coronary artery disease. Biofactors. 2012 Sep–Oct; 38(5):320–328 http://dx.doi.org/10.1002/biof.102410.1002/biof.1024Search in Google Scholar PubMed
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