36 year old male with a history of normal exercise SPECT and newly diagnosed left ventricular dysfunction referred for further evaluation with cardiac MRI Left VentricleThe left ventricle is mildly dilated with mildly reduced systolic function. The overall LV ejection fraction is 43%, the LV end diastolic volume index is 116 ml/m2 (normal range: 74+/-15), the LVEDV is 255 ml (normal range 142+/-34), the LV end systolic volume index is 66 ml/m2 (normal range 25+/-9), the LVESV is 147 ml (normal range 47+/-19), the LV mass index is 36 g/m2 (normal range 85+/-15), and the LV mass is 80 g (normal range 164+/-34). There is global hypokinesis with regional variation. There is no late gadolinium enhancement to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process. There is no evidence of myocardial iron overload. The pre-contrast native myocardial T1 relaxation times are 1000-1050 ms (normal). Left AtriumThe left atrium is mildly dilated. Right VentricleThe right ventricle is normal sized with mildly reduced systolic function. The overall RV ejection fraction is 42%, the RV end diastolic volume index is 90 ml/m2 (normal range 82+/-16), the RVEDV is 199 ml (normal range 142+/-31), the RV end systolic volume index is 53 ml/m2 (normal range 31+/-9), and the RVESV is 116 ml (normal range 54+/-17). Right AtriumThe right atrium is mildly dilated. Aortic ValveThe aortic valve opens widely and there is no significant aortic regurgitation.Mitral ValveThe mitral valve opens widely and there is no significant mitral regurgitation.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 are normal in size and drain normally into the right atrium. PericardiumThere is no obvious pericardial disease.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. The left ventricle is mildly dilated with mildly reduced systolic function (LVEF 43%). No evidence of late gadolinium enhancement to suggest presence of underlying fibrosing, infiltrative, or inflammatory process2. The right ventricle is normal sized with mildly reduced systolic function (RVEF 46%). 3. Mild biatrial enlargement. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.