Ananna Zaman1, Samantha Zhao1, Jordana Kron2, Antonio Abbate2, Anna Tomdio2, W Gregory Hundley2, Jennifer H Jordan3,4. 1. Department of Biomedical Engineering, Virginia Commonwealth University, Richmond, VA, USA. 2. Department of Internal Medicine, Pauley Heart Center, Virginia Commonwealth University, West Hospital, 8th Floor, 1200 E. Broad Street, Richmond, VA, 23298, USA. 3. Department of Biomedical Engineering, Virginia Commonwealth University, Richmond, VA, USA. JHJordan@vcu.edu. 4. Department of Internal Medicine, Pauley Heart Center, Virginia Commonwealth University, West Hospital, 8th Floor, 1200 E. Broad Street, Richmond, VA, 23298, USA. JHJordan@vcu.edu.
Abstract
PURPOSE OF REVIEW: This focused report aims to discuss and summarize the use of conventional and emerging methods using cardiovascular magnetic resonance (CMR) imaging in cardiomyopathy patients with implanted cardiac devices to identify diffuse and focal inflammation and fibrosis. RECENT FINDINGS: Many cardiomyopathy patients with diffuse and focal myocardial fibrosis have a unique need for cardiac imaging that is complicated by cardiovascular implantable electronic devices (CIEDs). CMR imaging can accurately image myocardial fibrosis and inflammation using T1 mapping and late gadolinium enhancement (LGE) imaging. CMR imaging in CIED patients, however, has been limited due to severe imaging artifacts associated with the devices. The emergence of wideband imaging variants of LGE and T1 mapping techniques can successfully reduce or eliminate CIED artifacts for the evaluation of myocardial substrate in cardiomyopathy patients. Wideband imaging variants of LGE and T1 mapping techniques provide new tools for imaging focal and diffuse fibrosis and imaging in cardiomyopathy patients with implanted cardiac devices. These emerging techniques have the potential for great impact in clinical care of such patients as well as clinical research where imaging endpoints are desired.
PURPOSE OF REVIEW: This focused report aims to discuss and summarize the use of conventional and emerging methods using cardiovascular magnetic resonance (CMR) imaging in cardiomyopathy patients with implanted cardiac devices to identify diffuse and focal inflammation and fibrosis. RECENT FINDINGS: Many cardiomyopathy patients with diffuse and focal myocardial fibrosis have a unique need for cardiac imaging that is complicated by cardiovascular implantable electronic devices (CIEDs). CMR imaging can accurately image myocardial fibrosis and inflammation using T1 mapping and late gadolinium enhancement (LGE) imaging. CMR imaging in CIED patients, however, has been limited due to severe imaging artifacts associated with the devices. The emergence of wideband imaging variants of LGE and T1 mapping techniques can successfully reduce or eliminate CIED artifacts for the evaluation of myocardial substrate in cardiomyopathy patients. Wideband imaging variants of LGE and T1 mapping techniques provide new tools for imaging focal and diffuse fibrosis and imaging in cardiomyopathy patients with implanted cardiac devices. These emerging techniques have the potential for great impact in clinical care of such patients as well as clinical research where imaging endpoints are desired.
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