Early Enhancement with Gadobutrol Can Visualize Diffuse Myocardial Fibrosis in Dilated Cardiomyopathy : A Cardiovascular Magnetic Resonance Study

Oliver Strohm¹, Myra Sabene Cocker¹, Matthias G. Friedrich¹

Dilated cardiomyopathy (DCM) is characterized by dilated ventricles and myocardial inflammation. Also present in DCM is diffuse, interstitial fibrosis. Current means of visualization of fibrosis is late gadolinium enhancement (LGE), but this requires the nulling of tissue to generate contrast between injured and healthy myocardium. However, in DCM there is the presence of diffuse fibrosis, which is also nulled for LGE. As such, LGE may not accurately assess diffuse fibrosis. However, early enhancement (EE) reflects early contrast uptake by myocardium, and has been found to be a surrogate marker of inflammation and hyperemia. Although, EE may also represent diffuse fibrosis. Thus, in this study, we sought to assess whether EE can assess diffuse fibrosis in patients with DCM.