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Expert speakers review the use of imaging for diagnosing the mysterious condition and for mastering its many faces during ECR 2010 , March 4 - 8, 2010 in Vienna.

They are a major cause of progressive heart failure and death, but cardiomyopathies can be tough to spot for clinicians, and missed cases can have fatal consequences. During ECR 10 special focus session, expert speakers reviewed the use of imaging for diagnosing the mysterious condition and for mastering its many faces.

Much of cardiac imaging practice is focused on characterization of coronary artery disease, and radiologists may be less familiar with primary cardiomyopathies, which are defined as diseases of the myocardium of unknown origin and are associated with cardiac dysfunction.

Conventional wisdom used to hold that cardiomyopathies were not very common, but imaging advances in MR and CT have enabled detection of more cases and helped uncover a heterogeneous group of diseases. Cardiomyopathies occur in about one in 5000 people, but the incidence can be much more or less common, depending on the disease type.

Five major types have been identified: dilated, restrictive, hypertrophic, arrythymogenic right ventricular, and “unclassified,” which includes several forms that are less commonly reported. Echocardiography has been the main imaging technique for diagnosis of cardiomyopathy and is still widely used, but MRI has become increasingly valuable in differentiating it from other conditions, such as heart attack and congenital heart disease.

Depending on the disease type, patients may present with a variety of symptoms, including breathlessness, exercise intolerance, and chest pain. Imaging is performed by both cardiologists and radiologists, and many centers are moving toward multidisciplinary assessment to achieve the best outcomes for patients.

During the focus session, Dr. Jonathan Dodd, a consultant radiologist at St. Vincent’s University Hospital in Dublin, reviewed the rarer forms and demonstrated their appearance on MRI . Several recent technological innovations in cardiac MRI are useful in evaluating cardiomyopathies, including vector ECG gating, rapid k-space sampling, and parallel imaging with surface coils. Gadolinium-enhanced MRI can be used to further evaluate changes within the myocardium, and it can aid in characterizing cardiomyopathies.

Source: ECR

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