Added value of CMR in the diagnosis and differentiation of cardiomyopathies
| Cardiomyopathy | Typical pattern of fibrosis seen on CMR which allows differentiation from Athletes Heart |
|---|---|
| HCM | Classically, fibrosis at the junction of the right ventricle and interventricular septum |
| Ischaemic DCM | Subendocardial extending to transmural fibrosis, generally restricted to the perfusion territory of one coronary artery |
| Non-ischaemic DCM | Patchy, mid-wall distribution in 28%. |
| Sub-endocardial pattern indistinguishable from ischaemic cardiomyopathy in 13% | |
| ARVC | Differentiated from Athlete's Heart as RV and LV show disproportionate changes. |
| LVNC | Non-compacted myocardium |
| Differentiated from Athlete's Heart as significant fibrosis in 55% of patients, which may occupy up to 5% of LV myocardium | |
| Myocarditis | Most commonly fibrosis has been shown to involve the epicardium of the inferior lateral wall. |
| Differentiated from Athlete's Heart due to lack of overt arrhythmias or classical symptoms (palpitations, presyncope or syncope) |
CMR, cardiovascular magnetic resonance; HCM,hypertrophic cardiomyopathy; DCM, dilated cardiomyopathy; ARVC,arrhythmogenic right ventricular cardiomyopathy; LVNC,left ventricular non-compaction