Cardiac Magnetic Resonance in the Evaluation and Management of Nonischemic Cardiomyopathies

Cardiac magnetic resonance is an essential tool in the evaluation and management of patients with suspected or diagnosed nonischemic cardiomyopathies (NICMs). It is considered the gold standard for accurately quantifying cardiac chamber dimensions, function, and mass, aiding in the initial diagnosis of myocardial dysfunction and/or dilation. Its unique value lies in its ability to characterize the myocardium using techniques such as late gadolinium enhancement, T1, T2, and T2∗ mapping, and extracellular volume fraction estimation, all of which have been histologically validated in specific clinical scenarios. These features enable specific diagnoses of the etiology of NICM, assess prognosis, guide management decisions, and potentially evaluate treatment response. This has allowed the widespread and increasing use of cardiac magnetic resonance in NICMs.