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

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 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 histology 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 determines prognosis in many of the non-ischemic cardiomyopathies. The use of CMR should increase as its utility in characterization and assessment of prognosis in cardiomyopathies is increasingly recognized. Cardiovascular magnetic resonance, cardiomyopathy, heart failure, hypertrophic cardiomyopathy, sarcoidosis, amyloidosis

Adenosine stress CMR perfusion imaging of the temporal evolution of perfusion defects in a porcine model of progressive obstructive coronary artery occlusion

“…In particular, quantitative perfusion more accurately characterizes the extent of ischemic myocardium. 12 While PET is currently the only clinically-available technique for quantitative myocardial perfusion imaging, 4 CMR offers numerous advantages over PET. Adenosine stress CMR perfusion imaging can quantify absolute perfusion and MPR in CAD with higher spatial resolution than PET (1.5-2.5 mm versus 4-6 mm, respectively) which may improve specificity for detection of CAD.…”

Free‐running 3D whole heart myocardial T1 mapping with isotropic spatial resolution

“…Cardiovascular magnetic resonance has been increasingly used to diagnose and monitor different cardiac diseases . Quantitative mapping of tissue parameters has demonstrated the potential to characterize subtle pathological changes of the myocardium and is especially valuable in detecting both focal and diffuse fibrosis .…”

“…Cardiovascular magnetic resonance has been increasingly used to diagnose and monitor different cardiac diseases. 1,2 Quantitative mapping of tissue parameters has demonstrated the potential to characterize subtle pathological changes of the myocardium and is especially valuable in detecting both focal and diffuse fibrosis. 3,4 T 1 is sensitive to the changes of myocardial tissue properties, such as fibrosis, fat, and water content, and therefore is considered a promising novel biomarker to characterize myocardium and assess various cardiomyopathies.…”

Simultaneous high‐resolution cardiac T1 mapping and cine imaging using model‐based iterative image reconstruction

“…Cardiovascular magnetic resonance provides a range of diagnostic parameters that allow for diagnosis and monitoring of different cardiac diseases and identification of even subtle pathological changes of the heart. 1,2 Cine imaging is performed for cardiac wall motion abnormalities and to quantify cardiac function. 3 Quantitative native T 1 mapping is becoming an important technique to detect fibrosis and diffuse cardiomyopathies.…”