JACC: CARDIOVASCULAR IMAGING

VOL.

ª 2015 BY THE AMERICAN COLLEGE OF CARDIOLOGY FOUNDATION

-, NO. -, 2015

ISSN 1936-878X/$36.00

PUBLISHED BY ELSEVIER INC.

LETTER TO THE EDITOR

CMR showed severe biatrial enlargement with reduced left ventricular ejection fraction (36%) and right ventricular ejection fraction (39%) (Online

Novel Use of Cardiac Magnetic Resonance

Video 2). Black-blood T2 images showed diffuse

Imaging for the Diagnosis of Cobalt

increased signal intensity (Figures 1A and 1B) and

Cardiomyopathy

imaging after late gadolinium enhancement (LGE) revealed diffuse

hyperenhancement

of

the

left

ventricle (Figures 1C and 1D). A 54-year-old male patient with bilateral metal-

Endomyocardial biopsy was performed (Figures 1E

on-metal hip prosthesis and recently diagnosed

and 1F). Iron, Congo red, and thioflavin T stains for

cobalt toxicity presented with gradually worsening

amyloid were negative. The patient underwent

symptoms of heart failure. Serum cobalt (120 m g/l;

replacement of both hip prostheses, which were found

normal