Nonischemic Cardiomyopathy - Mid-Wall LGE
了解 Left ventricle Cardiac MRI 影像中的 Nonischemic Cardiomyopathy - Mid-Wall LGE，明确其含义与下一步措施。
影像表现
Cardiac MRI FindingMid-wall late gadolinium enhancement in the basal to mid interventricular septum with mild global hypokinesis (LVEF 45%).
临床意义
Pattern favors nonischemic dilated cardiomyopathy rather than infarction; scar burden has prognostic value for arrhythmic risk.
What does the scan show?
Cardiac MRI with contrast demonstrates mid-wall LGE in the basal to mid septum and mild diffuse hypokinesis. No subendocardial or transmural scar is seen to suggest prior infarct. T2 mapping is normal.
Why it matters
Mid-wall LGE is typical of nonischemic dilated cardiomyopathy and correlates with higher risk of ventricular arrhythmias and heart failure events. Distinguishing ischemic vs. nonischemic etiology guides management and device therapy decisions.
Recommended next steps
- Optimize guideline-directed medical therapy for HFrEF and reassess LVEF after 3-6 months.
- Consider ambulatory rhythm monitoring; LGE extent can support ICD consideration if EF remains reduced.
- Evaluate secondary causes (viral, toxins, genetic); coronary disease already unlikely based on scar pattern.
Patient tips
- Take heart-failure medications consistently and track blood pressure/weight at home.
- Report palpitations, presyncope, or new swelling promptly; these can signal arrhythmia or decompensation.
搭配化验结果解读
当影像出现 Nonischemic Cardiomyopathy - Mid-Wall LGE 时，医生常会查看这些化验：
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