Cardiac magnetic resonance imaging (CMR) is an accurate and reliable means of evaluating cardiac morphology, ventricular function, and myocardial perfusion, both for the left and the right ventricle thereby covering a whole spectrum of cardiac diseases.
1 CMR is therefore very well suited for identifying and characterising patients with various manifestations of left ventricular hypertrophy (LVH).
2 For instance, CMR can resolve the question whether training-induced LVH in athletes is a physiological rather than a pathophysiological phenomenon. In a previous meta-analysis, involving 59 studies and 1451 athletes (both endurance-trained and strength-trained athletes), it was confirmed that the athlete's heart demonstrated normal systolic and diastolic cardiac function, implying that training-induced LVH in athletes is predominantly a physiological phenomenon.
3 CMR has also been shown of great value in patients with hypertrophic cardiomyopathy (HCM).
4-7 By virtue of its high spatial and temporal resolution, CMR is capable of accurately identifying regional deformities in patients with HCM. In particular, CMR tagging allows the evaluation of regional systolic and diastolic function after therapeutic interventions.
8 In recent years, late gadolinium enhancement CMR has been used to visualise myocardial interstitial abnormalities in patients with different forms of cardiomyopathies.
9 Late gadolinium enhancement was present in cardiomyopathy patients who showed a mean signal intensity 3-4 times higher than in normal regions.
10 The affected areas included papillary muscles (sarcoid), the mid-myocardium (Anderson-Fabry disease, glycogen storage disease, myocarditis, Becker and Duchenne muscular dystrophy) and the global subendocardium (systemic sclerosis, Loeffler’s endocarditis, amyloid, Churg-Strauss).
11 In these specific cardiomyopathies, a typical pattern of late gadolinium enhancement can be found which is overtly distinct from the enhancement patterns seen in myocardial infarction.
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