The morphology can be assessed, although it is limited in the evaluation of the right ventricle (RV). With the use of advanced techniques such as 3-D echocardiography, further subtyping of NICM is possible. Myocardial deformation can be evaluated using tissue Doppler imaging and speckle-tracking (2-D or 3-D). Abnormal global longitudinal strain enables detection of subclinical left ventricle (LV) dysfunction in several disease entities [11]. Doppler metrics are useful in evaluation of diastolic dysfunction, especially in restrictive cardiomyopathies and HCM [12]. However, routine echocardiography does not have tissue characterization capabilities. Contrast echocardiography can be used in the quantification of ventricular volumes and EF as well as regional wall motion when the routine images are suboptimal. It is also used in the evaluation of noncompaction, thrombus aneurysm, and apical lesions such as apical variant HCM, stress-induced cardiomyopathy, and endocardial fibroelastosis [13]. Cardiac CT Coronary CTA has a limited role in the evaluation of NICM, predominantly for excluding coronary artery disease (CAD) as the etiology of HF [15]. Cardiac CT can be used in the evaluation of morphology, characterization, and quantification of function in patients when echocardiography is suboptimal because of poor acoustic windows and MRI is suboptimal because of artifacts. The function and volumes obtained from CT correlate with other Nonischemic Myocardial Disease modalities including MRI [16,17]. With retrospective ECG-gated acquisition, dynamic and functional information can be obtained. First-pass myocardial perfusion can be used to evaluate for ischemia. Delayed iodine- enhancement imaging can show variable patterns of enhancement in NICM, albeit at a lower contrast-to-noise ratio compared with MRI.
Nonischemic Myocardial Disease with Clinical Manifestations Ischemic Cardiomyopathy Already Excluded . The morphology can be assessed, although it is limited in the evaluation of the right ventricle (RV). With the use of advanced techniques such as 3-D echocardiography, further subtyping of NICM is possible. Myocardial deformation can be evaluated using tissue Doppler imaging and speckle-tracking (2-D or 3-D). Abnormal global longitudinal strain enables detection of subclinical left ventricle (LV) dysfunction in several disease entities [11]. Doppler metrics are useful in evaluation of diastolic dysfunction, especially in restrictive cardiomyopathies and HCM [12]. However, routine echocardiography does not have tissue characterization capabilities. Contrast echocardiography can be used in the quantification of ventricular volumes and EF as well as regional wall motion when the routine images are suboptimal. It is also used in the evaluation of noncompaction, thrombus aneurysm, and apical lesions such as apical variant HCM, stress-induced cardiomyopathy, and endocardial fibroelastosis [13]. Cardiac CT Coronary CTA has a limited role in the evaluation of NICM, predominantly for excluding coronary artery disease (CAD) as the etiology of HF [15]. Cardiac CT can be used in the evaluation of morphology, characterization, and quantification of function in patients when echocardiography is suboptimal because of poor acoustic windows and MRI is suboptimal because of artifacts. The function and volumes obtained from CT correlate with other Nonischemic Myocardial Disease modalities including MRI [16,17]. With retrospective ECG-gated acquisition, dynamic and functional information can be obtained. First-pass myocardial perfusion can be used to evaluate for ischemia. Delayed iodine- enhancement imaging can show variable patterns of enhancement in NICM, albeit at a lower contrast-to-noise ratio compared with MRI.