55 year old woman with history of nonischemic cardiomyopathy and atrial arrhythmias referred for cardiac MR to evaluate for etiologies of her CM. Left VentricleThe left ventricle is mild-moderately dilated with severely reduced systolic function. The overall LV ejection fraction is 27%, the LV end diastolic volume index is 101 ml/m2 (normal range: 65+/-11), the LVEDV is 235 ml (normal range 109+/-23), the LV end systolic volume index is 74 ml/m2 (normal range 18+/-5), the LVESV is 173 ml (normal range 31+/-10), the LV mass index is 82 g/m2 (normal range 67+/-11), and the LV mass is 191 g (normal range 114+/-24). There is abnormal wall motion, with evidence of hypokinesis of the inferior, inferoseptum and anteroseptum, and possibly anterior wall but wall motion evaluation is suboptimal (unable to obtain long-axis views). Late gadolinium imaging is of limited diagnostic quality, but the following observations can be made: There is late gadolinium enhancement in the mid to apical inferior and inferolateral walls, which involves the subendocardium and could suggest previous myocardial infarction. There is no visual evidence of iron overload.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 38%, the RV end diastolic volume index is 68 ml/m2 (normal range 69+/-14), the RVEDV is 159 ml (normal range 110+/-24), the RV end systolic volume index is 42 ml/m2 (normal range 22+/-8), and the RVESV is 61 ml (normal range 35+/-13). Right AtriumThe right atrium is upper limits of normal. Aortic ValveThe aortic valve opens widely and there is no significant aortic regurgitation.Mitral ValveThe mitral valve opens widely and there is at least mild 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 mildly dilated. Venous AnatomyThe SVC and IVC are normal in size and drain normally into the right atrium. PericardiumThere is no obvious pericardial disease.Extracardiac Findings 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 moderately dilated with severely reduced systolic function (EF 27%).2. Late gadolinium imaging is of limited diagnostic quality, but the following observations can be made: There is late gadolinium enhancement in the mid to apical inferior and inferolateral walls, which involves the subendocardium and could suggest previous myocardial infarction. 3. The right ventricle is normal in size with moderately reduced systolic function (EF 38%).4. At least mild mitral regurgitation. 5. Severe left atrial dilation. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.