Dilated cardiomyopathy

Dilated cardiomyopathy (DCM) is a common cause of heart failure in the general population. In the past decade, the prognosis of DCM patients has improved significantly, thanks to advances in medical therapy and the introduction of device(s) treatment. Despite these advances, the 10-year survival remains <60%, with deaths often preceded by numerous heart failure exacerbations, reflecting the difficulty associated with individual risk stratification. The clinical course varies widely, ranging from progressive heart failure or sudden death to excellent recovery of left ventricular function and good prognosis. Cardiovascular magnetic resonance (CMR) has progressively gained acceptance in the workup of patients with DCM, allowing a precise and non-invasive quantification of left and right ventricular volumes, mass, and function, along with tissue characterization of the myocardium. CMR plays a crucial clinical role in DCM patients by helping to identify the potential aetiology and to assess for novel CMR prognostic markers improving risk stratification. Recent evidence also suggests that CMR has a role in the selection of candidates who likely benefit from device(s) therapy.