Cardiovascular ImagingCardiomyopathy, restrictive
primary disease of
cardiac muscle causing depression of diastolic ventricular function with normal or only slight increase in ventricular volumes. Ventricular diastolic pressures are impressively increased with little or no increase in diastolic volumes. End-systolic volume is usually slightly increased and
stroke volume mildly reduced. The atria are usually enlarged. Infiltrative diseases, especially amyloidosis, frequently cause the restrictive form of
cardiomyopathy which may be referred to as
infiltrative cardiomyopathy. Also, see
cardiomyopathy amyloid.
Radiography shows no or mild cardiomegaly, left atrial enlargement and pulmonary venous hypertension or oedema. Echocardiography, electron beam CT, MRI and ventriculography demonstrate normal or only mildly increased ventricular volumes, abnormal diastolic filling pattern and mild generalized hypokinesis. Doppler echocardiography and velocity-encoded cine MRI demonstrate reduced diastolic filling indices. CT and MRI are used to exclude pericardial thickening as the aetiology of the elevated diastolic pressure on both sides of the heart. MRI is the optimal technique for demonstrating enlargement of the atria and inferior vena cava (Fig.1). The atrial cavitary signal is impressive due to the relative stasis of the blood.
CBH
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ECG-gated spin-echo image demonstrates enlargement of both atria and normal size of the ventricles. Intracavitary signal in the atria is caused by relative stasis of blood due to restriction of ventricular filling.
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Cardiomyopathy, restrictive, Fig.1 | |