A 33 year old male with personal history of diabetes mellitus, hypertension and end stage renal disease on dialysis treatment. Now hospitalized with heart failure symptoms. An echocardiography study showed preserved systolic function with left ventricular hypertrophy. Referred to cardiac MRI for further evaluation. Left VentricleThe left ventricle is severely dilated with mildly reduced systolic function. The overall LV ejection fraction is 51%, the LV end diastolic volume index is 134 ml/m2 (normal range: 74+/-15), the LVEDV is 278 ml (normal range 142+/-34), the LV end systolic volume index is 66 ml/m2 (normal range 25+/-9), the LVESV is 137 ml (normal range 47+/-19). There is global left ventricular concentric hypertrophy maximal at basal antero-septum of 16mm. LV dysfunction is global. Native T1-mapping showed normal native times at base, mid and apical segments.Left AtriumThe left atrium is mildly enlarged (122ml). Right VentricleThe right ventricle is mildly dilated with normal systolic function. The overall RV ejection fraction is 66%, the RV end diastolic volume index is 114 ml/m2 (normal range 82+/-16), the RVEDV is 238 ml (normal range 142+/-31), the RV end systolic volume index is 38 ml/m2 (normal range 31+/-9), and the RVESV is 79 ml (normal range 54+/-17).Right AtriumThe right atrium is normal in size.Aortic ValveThe aortic valve opens widely and there is no significant aortic regurgitation.Mitral ValveThe mitral valve opens widely and there is mild mitral regurgitation.Pulmonic ValveThe pulmonic valve opens widely. There is no significant pulmonic regurgitation.Tricuspid ValveThe tricuspid valve opens widely. There is trace 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 drain normally into the right atrium. Dilated IVC. There is a catheter in the SVC.PericardiumThere is no obvious pericardial disease.Extracardiac FindingsThere is small pleural effusion on the left lung and trivial on the right lung. This 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 severely dilated with mildly reduced systolic function, the LVEF is 51%. There is global left ventricular concentric hypertrophy maximal at basal antero-septum of 16mm. Native T1-mapping showed normal native times at base, mid and apical segments, which does not suggest myocardial infiltration. Delayed enhancement imaging not performed due to ESRD.2. The left atrium is mildly enlarged. 3. The right ventricle is mildly dilated with normal systolic function, the RVEF is 66%. 4. There is mild mitral regurgitation.5. There is a catheter in the SVC.6. See extracardiac findings. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.