Little is known about the clinical value of late gadolinium enhancement (LGE), in children affected by dilated cardiomyopathy (DCM).We retrospectively evaluated 15 patients (8?▒?6?years, 6 males) with diagnosis of DCM who underwent cardiac magnetic resonance since 2014. All scans were performed with a 1.5?T system (Aera, Siemens). Study protocol included cine steady-state free precession sequences, followed by administration of 0.2?mmol/kg of gadolinium-based contrast agent. Inversion recovery Turbo Flash sequences, in the same position of cine images, were acquired 10-15?min after the injection of contrast agent, in order to assess the presence of LGE. The latter was considered positive with a signal intensity >6 SD from normal myocardial tissue. Indexed end-diastolic volume (EDVi) and end-systolic volume (ESVi), and left ventricle (LV) ejection fraction (EF) were calculated by using dedicated software on off-line workstation. Global longitudinal strain and diastolic function were evaluated by echocardiography. Clinical follow-up, including death, transplant, and listing for heart transplant [major adverse cardiac events (MACE)], were evaluated. Patients were divided into two different subgroups: negative (Group A) and positive (Group B) for presence of LGE. Statistical analysis was performed by using Mann-Whitney U test (p?0.05 considered as statistically significant).Seven patients (47%) showed LGE. A global diffuse subendocardial pattern was evident in all patients presenting LGE (7/7, 100%). The following main LV indexes were observed in the two subgroups. Group A: EDVi?=?96?▒?33?ml, ESVi?=?56?▒?29?ml, LV EF?=?45?▒?10%, global longitudinal strain?=?-16?▒?5%, E/e' ratio?=?10?▒?3, MACE?=?1. Group B: EDVi?=?130?▒?60?ml, ESVi?=?89?▒?43?ml, LV EF?=?31?▒?6%, global longitudinal strain?=?-13?▒?4%, E/e' ratio?=?9?▒?3, MACE?=?3. There was no statistically significant difference between the two groups, in terms of EDVi (p: 0.2), ESVi (p: 0.2), and E/e' ratio (0.9), whereas a significant difference of LV EF, presence of significative mitral regurgitation, and global longitudinal strain were observed (respectively, p: 0.03, p: 0.009, and p: 0.03).In our population of children with DCM, LGE shows a global diffuse subendocardial pattern. Presence of LGE seems to play a role in these patients determining a worst global systolic function.
View details for DOI 10.3389/fped.2017.00013
View details for Web of Science ID 000393308600002
View details for PubMedID 28220144
View details for PubMedCentralID PMC5292614