CMR in Heart Failure: Current and Emerging Clinical Applications

Heart failure is the potential result of a large number of heterogeneous diseases leaving the heart unable to provide an adequate blood supply for the body. The optimal diagnosis and management of this diverse syndrome requires the accurate synthesis of a large amount of clinical information but often the underlying diagnosis is elusive. The use of Cardiac Magnetic Resonance (CMR) is growing rapidly and it has established itself as a powerful, non-invasive, non-ionising radiation based tool. CMR is able to interrogate not only ventricular function and morphology but also characterise the tissue itself on a scale validated with histology, investigate cellular function as well as myocardial mechanics and energetics. Within this chapter we will summarise for the reader the current use of CMR in heart failure, the emerging pulse sequences and the state of the art application of CMR in specific settings within heart failure. CMR is already proven to make significant clinical impact but challenges remain in harnessing the wealth of information it can provide, proving the incremental value of each technique and in widening the availability of CMR in order to maximise its benefit. This chapter will provide an in-depth introduction to the topic, act as an update for the more advanced practitioner and provide a platform for further interest and research.

Keywords: Acquired cardiomyopathy, cardiac magnetic resonance, cardiac resynchronization, cardiac transplantation, diagnosis, dilated cardiomyopathy, fibrosis, gadolinium, heart failure, imaging, inherited cardiomyopathy, ischaemic heart disease, myocardial function, myocardial edema, myocardial characterization, perfusion, prognosis, valvular heart disease.