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STATE-OF-THE-ART PAPER

The Role of Cardiovascular Magnetic Resonance Imaging in Heart Failure

Theodoros D. Karamitsos, MD, PhD^_*, Jane M. Francis, DCC(R), DNM^_*, Saul Myerson, MD^_*, Joseph B. Selvanayagam, MBBS, DPhil and Stefan Neubauer, MD^_*,_*

^_* University of Oxford Centre for Clinical Magnetic Resonance Research, Department of Cardiovascular Medicine, John Radcliffe Hospital, Oxford, United Kingdom
Department of Cardiovascular Medicine, Flinders Medical Centre, Adelaide, Australia

Manuscript received February 25, 2009; revised manuscript received April 14, 2009, accepted April 28, 2009.

^_* Reprint requests and correspondence: Dr. Stefan Neubauer, Department of Cardiovascular Medicine, John Radcliffe Hospital, Headley Way, Headington, OX3 9DU Oxford, United Kingdom (Email: stefan.neubauer{at}cardiov.ox.ac.uk).

Noninvasive imaging plays a central role in the diagnosis of heart failure, assessment of prognosis, and monitoring of therapy. Cardiovascular magnetic resonance (CMR) offers a comprehensive assessment of heart failure patients and is now the gold standard imaging technique to assess myocardial anatomy, regional and global function, and viability. Furthermore, it allows assessment of perfusion and acute tissue injury (edema and necrosis), whereas in nonischemic heart failure, fibrosis, infiltration, and iron overload can be detected. The information derived from CMR often reveals the underlying etiology of heart failure, and its high measurement accuracy makes it an ideal technique for monitoring disease progression and the effects of treatment. Evidence on the prognostic value of CMR-derived parameters in heart failure is rapidly emerging. This review summarizes the advantages of CMR for patients with heart failure and its important role in key areas.

Key Words: left ventricular dysfunction • heart failure • ischemia • diagnosis • therapy • prognosis • cardiovascular magnetic resonance imaging

Abbreviations and Acronyms   ARVC = arrhythmogenic right ventricular cardiomyopathy   CAD = coronary artery disease   CMR = cardiovascular magnetic resonance   CRT = cardiac resynchronization therapy   DCM = dilated cardiomyopathy   HCM = hypertrophic cardiomyopathy   HF = heart failure   LGE = late gadolinium enhancement   LV = left ventricular   MR = magnetic resonance   RV = right ventricular

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