Late gadolinium enhancement on cardiac magnetic resonance images predicts reverse remodeling in patients with nonischemic cardiomyopathy treated with carvedilol

Abstract

Several studies have demonstrated the improvement of left ventricular ejection fraction (LVEF) in heart failure patients after the long-term treatment with beta blockers [ [1] Hori M. Sasayama S. Kitabatake A. et al. Low-dose carvedilol improves left ventricular function and reduces cardiovascular hospitalization in Japanese patients with chronic heart failure: the Multicenter Carvedilol Heart Failure Dose Assessment (MUCHA) trial. Am Heart J. 2004; 147: 324-330 Abstract Full Text Full Text PDF PubMed Scopus (133) Google Scholar ], although, not all patients have similar results. To date, it has not been fully investigated that patients with systolic heart failure respond uniformly to this therapy. Myocardial fibrosis triggers impaired cardiac systolic function and has an association with adverse cardiovascular events [ 2 Wu K.C. Weiss R.G. Thiemann D.R. et al. Late gadolinium enhancement by cardiovascular magnetic resonance heralds an adverse prognosis in nonischemic cardiomyopathy. J Am Coll Cardiol. 2008; 51: 2414-2421 Abstract Full Text Full Text PDF PubMed Scopus (444) Google Scholar , 3 Cho J.R. Park S. Choi B.W. et al. Delayed enhancement magnetic resonance imaging is a significant prognostic factor in patients with non-ischemic cardiomyopathy. Circ J. 2010; 74: 476-483 Crossref PubMed Scopus (25) Google Scholar ]. Nowadays, late gadolinium enhancement (LGE) on cardiac magnetic resonance images (CMR) is widely used to assess myocardial tissue viability [ 4 Schalla S. Bekkers S.C. Dennert R. et al. Replacement and reactive myocardial fibrosis in idiopathic dilated cardiomyopathy: comparison of magnetic resonance imaging with right ventricular biopsy. Eur J Heart Fail. 2010; 12: 227-231 Crossref PubMed Scopus (60) Google Scholar , 5 Park S. Choi B.W. Rim S.J. et al. Delayed hyperenhancement magnetic resonance imaging is useful in predicting functional recovery of nonischemic left ventricular systolic dysfunction. J Card Fail. 2006; 12: 93-99 Abstract Full Text Full Text PDF PubMed Scopus (22) Google Scholar ]. This study was designed to investigate whether myocardial fibrosis determined by LGE on CMR would be useful to assess left ventricular reverse remodeling (LVRR) in patients with nonischemic cardiomyopathy (NICM) treated with beta blockers.