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Methods We studied 176 consecutive patients (61 ± 13 years, 73% men) with severe LV systolic dysfunction (mean ejection fraction (24 ± 8%) who underwent DHE-MRI on 1.5 T MR scanners (Siemens, Erlangen, Germany) from 2005–6. DHE-MR images were obtained in standard long and short axis orientations (covering the entire LV), after injection of Gadolinium dimenglumine using an inversion recovery spoiled gradient echo sequence: TE 4 msec, TR 8 msec, flip angle 30°, bandwidth 140 Hz/pixel, 23 k-space lines acquired every other RR-interval, field of view (varied from 228–330 in the x-direction and 260–330 in the y-direction) and matrix size (varied from 140–180 in the x-direction and 256 in the y-direction). For DHE-MRI analysis, a custom analysis package (VPT software, Siemens, Erlangen, Germany) was used to manually delineate endocardial and epicardial myocardial edges. Scar was defined as having intensity >2 SD above viable myocardium (identified by a user-specified region of interest). Glomerular filtration rate (GFR, ml/min/1.73 m2) was calculated using the following formula: 186 × (serum creatinine-1.154) × (age-0.203) × 1.212 (if black) × 0.742 (if female). We divided patients into 4 groups: 1) GFR > 60, no scar (n = 28) 2) GFR > 60 with scar (n = 85) 3) GFR ≤ 60, no scar (n = 9) and 4) GFR ≤ 60 with scar (n = 53).

journal of cardiovascular magnetic resonance

1031 Renal dysfunction, in association with myocardial fibrosis leads to worse survival in patients with severe left ventricular dysfunction: a delayed hyperenhancement MRI study