Cardiomyopathies

Abstract

Cardiovascular magnetic resonance (CMR) is generally recognized as the most informative imaging technology for assessing patients with non-ischaemic cardiomyopathies. Beyond its standard-of-reference-quality quantitative data, it provides unique information on myocardial tissue characteristics that allows for the detection, localization, and spatial quantification of myocardial oedema, fibrosis, and infiltration. This not only provides an accurate discrimination of non-ischaemic from ischaemic myocardial disease, but also has led to very specific diagnostic criteria for certain cardiomyopathies (e.g. myocarditis, cardiac amyloidosis, myocardial iron overload, stress-induced cardiomyopathy Takotsubo, or Fabry’s disease). Furthermore, CMR provides criteria for acute versus remote injury and, depending on the clinical context, evidence for myocardial inflammation such as in viral myocarditis. The chapter presents and discusses the important aspects of the clinical application of CMR in non-ischaemic cardiomyopathies with a focus on useful scan protocols, typical findings, added diagnostic value, and limitations. New approaches such as cardiac T1 mapping and T2 mapping are included. Key references on the current state-of-the-art use of CMR are provided and discussed.