Preoperative contrast-enhanced magnetic resonance imaging in ischemic cardiomyopathy patients undergoing surgical left ventricular reconstruction

Purpose. The aim of this study was to identify the signifi cance of myocardial viability indicators calculated based on cardiac magnetic resonance imaging (MRI) with delayed contrast, as predictors of the adverse course of postoperative period in the surgical treatment of patients with ischemic cardiomyopathy.

Material and Methods. A total of 178 patients underwent surgical treatment for ischemic cardiomyopathy from March, 2013 to December, 2017. All patients underwent preoperative cardiac MRI scan with paramagnetic contrast.

Results. The logistic regression analysis showed that the left ventricular volumetric indicators and the amount of residual viable myocardium, calculated using delayed contrast-enhanced MRI, were the essential predictors of favorable and complicated course of postoperative period in ischemic cardiomyopathy patients. In patients with a residual viable left ventricular myocardium amount over 64.5%, surgical ventricular reconstruction procedure may be performed with a low risk of early postoperative complications (OR 8.25, 95% CI 1.45-46.8, p = 0.017).

Conclusion. Cardiac MRI with delayed paramagnetic contrasting is a valuable method contributing to the preoperative identifi cation of a cohort of ischemic cardiomyopathy patients who can benefi t the most from surgical left ventricular reconstruction. 

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