SCMR/Medis: CMR in Cardiomyopathies: How to do it?-SCMR/MEDIS: CMR in Heart Failure: How to do it?

Video Transcription

Video Summary

This SCMR webinar focused on how cardiac MRI is used in cardiomyopathies, with two talks covering practical protocols, key imaging findings, and clinical decision-making.<br /><br />Dr. Attila Todt opened by emphasizing that CMR has a class I recommendation in most cardiomyopathies for morphological and functional characterization, and often for follow-up. He reviewed core sequences including cine imaging, T1/T2 mapping, edema imaging, and late gadolinium enhancement (LGE), noting technical pitfalls such as coil settings and vendor differences in mapping. He discussed dilated cardiomyopathy, showing how CMR can uncover specific causes such as myocarditis, athlete’s heart, dystrophies, iron overload, and sarcoidosis. He also covered arrhythmogenic cardiomyopathy, including biventricular and left-dominant variants, and highlighted the role of LGE, genetics, and wideband imaging in patients with devices. Additional topics included left ventricular non-compaction, apical thrombus, and endomyocardial fibrosis.<br /><br />Dr. Alexander Heers then focused on hypertrophic cardiomyopathy and the importance of deep phenotyping with CMR. He stressed LGE and mapping for diagnosis, phenocopy detection, and prognosis. He presented cases of sarcomeric HCM, amyloidosis, mitochondrial disease, and filamin C-related ring-like LGE, highlighting how imaging can guide risk stratification and ICD decisions. Both speakers discussed the difficulty of quantifying LGE, the importance of reporting RV volumes and function, and the need for thoughtful, clinically integrated CMR interpretation rather than relying on numbers alone.

Keywords

cardiac MRI

cardiomyopathies

CMR protocols

late gadolinium enhancement

T1 mapping

T2 mapping

hypertrophic cardiomyopathy

dilated cardiomyopathy

arrhythmogenic cardiomyopathy

risk stratification