42 year old female with hypertension and new cardiomyopathy, referred to evaluate for etiology of LV dysfunction. Left VentricleThe left ventricle is severely dilated with moderate-severely reduced systolic function. The overall LV ejection fraction is 31%, the LV end diastolic volume index is 117 ml/m2 (normal range: 65+/-11), the LVEDV is 278 ml (normal range 109+/-23), the LV end systolic volume index is 80 ml/m2 (normal range 18+/-5), the LVESV is 191 ml (normal range 31+/-10). There is global hypokinesis with regional variation. LVH is present with LV wall thickness of 12-13 mm (despite LV enlargement).There is no late gadolinium enhancement to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process.The native T1 myocardial relaxation time is 1080-1120ms. This is borderline abnormal. The extracellular volume fraction could not be reliably assessed.There is no myocardial iron overload. There is no LV thrombus. Left AtriumThe left atrium is severely dilated.Right VentricleThe right ventricle is normal in size with mildly reduced systolic function. The overall RV ejection fraction is 39%, the RV end diastolic volume index is 46 ml/m2 (normal range 69+/-14), the RVEDV is 109 ml (normal range 110+/-24), the RV end systolic volume index is 30 ml/m2 (normal range 22+/-8), and the RVESV is 71 ml (normal range 35+/-13). Right AtriumThe right atrium is moderately dilated. Aortic ValveThe aortic valve opens widely and there is no significant aortic regurgitation.Mitral ValveThe mitral valve opens widely. There is at least moderate mitral regurgitation which is central.Pulmonic ValveThe pulmonic valve opens widely. There is no significant pulmonic regurgitation.Tricuspid ValveThe tricuspid valve opens widely. There is no significant tricuspid regurgitation.AortaThere is a left sided aortic arch with a normal brachiocephalic branching pattern. The aortic root is normal in size.Pulmonary VeinsAll four pulmonary veins drain normally into the left atrium.Pulmonary ArteryThe main pulmonary artery is normal in size. Venous AnatomyThe SVC and IVC drain normally into the right atrium. PericardiumThere is a trivial pericardial effusion.Extracardiac FindingsThis study is not designed for the specific evaluation of extra-cardiac findings; therefore, the differentiation between artifacts and real extracardiac pathology may be difficult. If clinically indicated, a separate dedicated evaluation should be considered.
1. Severely dilated left ventricle with moderate-severely reduced systolic function (EF 31%).2. Borderline elevated native T1 myocardial relaxation times (1080-1120ms) with no evidence of late gadolinium enhancement. This may suggest mild diffuse interstitial fibrosis. 3. Normal size right ventricle with mildly reduced systolic function (EF 39%).4. At least moderate mitral regurgitation.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.