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Background Patients with ischemic cardiomyopathy (CMP) often develop regional wall motion abnormalities (WMA) due to myocardial scarring, stunning or hibernation. Abnormal functioning myocardial segments without evidence of fibrosis on late gadolinium-enhancement cardiac magnetic resonance (LGE-CMR) are felt to represent stunned or hibernating myocardium, presumably with significant coronary artery disease (CAD) in the vessel supplying the region. We analyzed the association between segmental wall motion abnormalities (WMA) and underlying CAD in ischemic CMP. Methods 53 consecutive patients referred for LGE-CMR with recent coronary angiography ( 50% transmural LGE, consistent with larger extent of WMA compared to LGE. No significant correlations were found between segments with any WMA and >50% transmural LGE (r= 0.05, p=0.71.). Of the 53 patients with ischemic CMP by LGE-CMR, 47 patients (89%) had documented coronary artery disease by angiography. There was no significant correlation between number of vessels with severe stenoses (>70%) and any WMA (r=0.19, p=0.18). Additionally, the number of segments with evidence of any WMA was more extensive than number of segments supplied by severe stenoses. Conclusions

journal of cardiovascular magnetic resonance

Extent of wall motion abnormalities with cardiovascular magnetic resonance imaging overestimates the degree of coronary artery disease in patients with ischemic cardiomyopathy