Cardiac magnetic resonance imaging in acute and chronic myocardial ischemia: current clinical application and future directions

Ischemic heart disease, its sequelae and complications contribute substantially to morbidity and mortality worldwide. Significant technological progress in recent years has significantly expanded the application of non-invasive imaging modalities in the systematic and complex evaluation of patients with ischemic heart disease in the preclinical and clinically developed stages of the disease. Cardiac magnetic resonance imaging includes a complex morphological and functional assessment. Regional and global myocardial kinetics and function, morphological changes in myocardial tissue in the form of edema, hemorrhage, and scarring determine various manifestations of myocardial ischemia in its acute and chronic form. Currently established clinical protocols have already demonstrated their diagnostic and prognostic value. Under the influence of unceasing clinical interest, cardiac magnetic resonance imaging is constantly developing and improving with emerging imaging technologies that provide additional information based on advanced quantification of imaging biomarkers and improved diagnostic accuracy, therefore potentially allowing reduction or avoidance of contrast and/or stressor agents.