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Cardio MRI Useful in Diagnosis of Stress Cardiomyopathy

Using specific criteria, cardiovascular magnetic resonance imaging identifies stress cardiomyopathy

TUESDAY, July 19 (HealthDay News) -- Cardiovascular magnetic resonance (CMR) imaging data can accurately diagnose stress cardiomyopathy (SC) based on specific criteria, according to a study published in the July 20 issue of the Journal of the American Medical Association.

Ingo Eitel, M.D., from the University of Leipzig in Germany, and colleagues evaluated the presentation of SC and sought to develop a set of CMR diagnostic criteria for patients presenting with suspected SC. A total of 256 patients with SC from seven tertiary care centers in Europe and North America underwent CMR at presentation between January 2005 and October 2010, and one to six months later. CMR data were available for 239 patients. The primary outcome measure was complete recovery from abnormal left ventricular (LV) contraction patterns.

The investigators found that 81 percent of the patients with SC were postmenopausal women, 8 percent were women aged 50 years or younger, and 11 percent were men. SC was precipitated by a stressful trigger in 71 percent of the patients. CMR imaging showed four regional ventricular ballooning patterns: apical (82 percent), biventricular (34 percent), midventricular (17 percent), and basal (1 percent). All patients showed a reduced LV ejection fraction. Specific CMR imaging criteria accurately identified SC: a typical pattern of LV dysfunction, myocardial edema, absence of significant necrosis/fibrosis, and markers for myocardial inflammation. Complete normalization of LV ejection fraction and inflammatory markers in the absence of significant fibrosis in all patients was seen at follow-up CMR imaging.

"CMR imaging at the time of initial clinical presentation may provide relevant functional and tissue information that might aid in the establishment of the diagnosis of SC," the authors write.

One of the study authors disclosed financial ties to the medical device industry.

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