Magnetic Resonance Imaging for Assessing Ventricular Volume and Function in Alcoholic Cardiomyopathy

Abstract

Alcoholic cardiomyopathy (ACM) is difficult to diagnose until clinical congestive heart failure (CHF) appears. Earlier recognition and treatment might halt progression to CHF. We used ECG-gated, fast-field echo, short-axis 1H magnetic resonance images (MRI) to evaluate left ventricular (LV) function in 4 normal subjects, 4 chronic alcoholic patients with CHF, and 4 chronic alcoholic patients. MRI images were analyzed to generate volume-versus-time curves. LV mass (LVM) and volume data were derived as follows: end-diastolic volume (EDV) and EDV index (EDVI) and end-systolic volume (ESV) and ESV index (ESVI); stroke volume (SV) and SV index (SVI), LVM and LVM index (LVMI) and ejection fraction (EF). In ACM patients, EDVI (121 ± 30 cm^3) and ESVI (90 ± 20 cm^3) were significantly increased (p < 0.001), and EF was significantly decreased (27 ± 9%) compared to normal patients (64 ± 6%; p < 0.001). In ACM and asymptomatic (ASX) patients, LVMI (64 ± 15, 72 + 9 g/m^2, respectively) was greater than in normals (48 ± 9 g/m^2; p < 0.01 and p < 0.001, respectively); this was the only parameter that differed in ASX versus normal subjects. MRI measurement of LV function and mass is an effective tool for documenting the clinical and subclinical effects of alcohol on the heart.