2026 SCMR Board Exam Review Course-Session 4: Nonischemic heart disease

Video Transcription

Video Summary

The transcript is a CMR board review course covering several cardiomyopathy topics and how cardiac MRI helps diagnosis, risk stratification, and management.<br /><br />For hypertrophic cardiomyopathy, the speaker emphasized that CMR is useful to measure true wall thickness, define HCM morphology, assess LVOT/SAM-related anatomy, quantify mitral regurgitation, identify nonischemic LGE patterns, estimate prognosis, and evaluate myocardial blood flow. Important points included that LGE can progress over time, there is no consensus on the best LGE quantification method, and coronary microvascular dysfunction is common in HCM.<br /><br />Other talks covered ARVC/genetic cardiomyopathy and cardiac sarcoidosis. CMR can detect fibrosis and phenotype disease even when echo is normal, and sarcoidosis diagnosis relies on characteristic LGE patterns, especially “pathology-frequent” septal/RV/multifocal involvement, which also predicts arrhythmic risk and ICD decisions.<br /><br />A major section reviewed infiltrative/storage diseases, especially amyloidosis, iron overload, and Fabry disease. CMR tissue characterization with T1, T2, T2*, extracellular volume, and LGE helps distinguish these entities, assess severity, and track treatment response. T2* is the gold standard for myocardial iron, while low T1 suggests Fabry disease and diffuse subendocardial/transmural LGE with abnormal nulling suggests amyloidosis.<br /><br />The course also covered dilated cardiomyopathy, excessive trabeculation/non-compaction, and athlete’s heart. The panel argued that “non-compaction” is often better called excessive trabeculation and should not drive management by itself. In athletes, CMR helps distinguish physiologic remodeling from cardiomyopathy by showing chamber size, wall thickness, normal function, and absence of pathologic scar.

Asset Caption

Ibrahim Saeed: CMR for Assessing HCM - 16 mins
Chetan Shenoy: CCMR for Assessing Sarcoid and ARVC - 28 mins
Amit Patel: CMR for Infiltrative and Storage Heart Disease - 23 mins
Steffen Petersen: CMR for Assessing DCM and Non-Compaction - 15 mins
Vineeta Ojha: CMR for iron Overload Cardiomyopathy - 20 mins
Matt Martinez: CMR for Differentiating Athlete's Heart from Cardiomyopathies - 17 mins
Amit Patel and Ron Jacob: Moderated Q&A with Speakers -45 mins

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Keywords

cardiomyopathy

cardiac MRI

hypertrophic cardiomyopathy

LGE

ARVC

cardiac sarcoidosis

amyloidosis

iron overload

Fabry disease

T1 mapping

T2*

extracellular volume

dilated cardiomyopathy

excessive trabeculation

athlete's heart