Magnetic resonance imaging in the assessment of ventricular remodeling and viability

Cardiovascular MRI has effectively become a reference standard for quantifying ventricular volumes and function and for measuring the myocardial scar burden after myocardial infarction. Imaging of late gadolinium enhancement and microvascular obstruction carries strong prognostic information for identifying patients who would benefit from anti-remodeling therapy. The combination of gadolinium enhancement, perfusion, and cine imaging should make MRI the modality of choice in the assessment of left ventricular dysfunction and remodeling. The use of MRI in clinical trials of heart failure could help reduce sample size requirements because of its accuracy and reproducibility. This review describes the use of MRI in assessing ventricular remodeling and viability and summarizes the few studies that have relied on MRI for image-based markers of ventricular remodeling.