Role of Cardiac Magnetic Resonance in the Diagnosis and Prognosis of Nonischemic Cardiomyopathy

JACC Cardiovasc Imaging. 2017 Oct;10(10 Pt A):1180-1193. doi: 10.1016/j.jcmg.2017.08.005.

Abstract

Cardiac magnetic resonance (CMR) is a valuable tool for the evaluation of patients with, or at risk for, heart failure and has a growing impact on diagnosis, clinical management, and decision making. Through its ability to characterize the myocardium by using multiple different imaging parameters, it provides insight into the etiology of the underlying heart failure and its prognosis. CMR is widely accepted as the reference standard for quantifying chamber size and ejection fraction. Additionally, tissue characterization techniques such as late gadolinium enhancement (LGE) and other quantitative parameters such as T1 mapping, both native and with measurement of extracellular volume fraction; T2 mapping; and T2* mapping have been validated against histological findings in a wide range of clinical scenarios. In particular, the pattern of LGE in the myocardium can help determine the underlying etiology of the heart failure. The presence and extent of LGE determine prognosis in many of the nonischemic cardiomyopathies. The use of CMR should increase as its utility in characterization and assessment of prognosis in cardiomyopathies is increasingly recognized.

Keywords: amyloidosis; cardiomyopathy; cardiovascular magnetic resonance; heart failure; hypertrophic cardiomyopathy; sarcoidosis.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't
  • Research Support, N.I.H., Extramural

MeSH terms

  • Amyloidosis / diagnostic imaging
  • Cardiomyopathies / diagnostic imaging*
  • Cardiomyopathies / genetics
  • Cardiomyopathies / therapy
  • Cardiomyopathy, Dilated / diagnostic imaging
  • Cardiomyopathy, Hypertrophic / diagnostic imaging
  • Contrast Media / administration & dosage
  • Genetic Predisposition to Disease
  • Hemosiderosis / diagnostic imaging
  • Humans
  • Image Interpretation, Computer-Assisted
  • Magnetic Resonance Imaging*
  • Predictive Value of Tests
  • Prognosis
  • Risk Factors
  • Sarcoidosis / diagnostic imaging
  • Severity of Illness Index

Substances

  • Contrast Media