Cardiovascular Magnetic Resonance Imaging of Myocardial Infarction, Viability, and Cardiomyopathies

Cardiovascular magnetic resonance provides the opportunity for a truly comprehensive evaluation of patients with a history of myocardial infarction, with regard to characterizing the extent of disease, effect on left ventricular function, and degree of viable myocardium. The use of contrast-enhanced cardiac magnetic resonance (CMR) imaging for first-pass perfusion and late gadolinium enhancement is a powerful technique for delineating areas of myocardial ischemia and infarction. Using a combination of T2-weighted and contrast-enhanced CMR images, information about the acuity of an infarct can be obtained. There is extensive published data using contrast-enhanced CMR to predict myocardial functional recovery with revascularization in patients with ischemic cardiomyopathies. In addition, CMR imaging in patients with cardiomyopathies can distinguish between ischemic and nonischemic etiologies, with the ability to further characterize the underlying pathology of nonischemic cardiomyopathies.