Heart failure is the potential result of a large number of heterogeneous
diseases leaving the heart unable to provide an adequate blood supply for the body. The
optimal diagnosis and management of this diverse syndrome requires the accurate
synthesis of a large amount of clinical information but often the underlying diagnosis is
elusive. The use of Cardiac Magnetic Resonance (CMR) is growing rapidly and it has
established itself as a powerful, non-invasive, non-ionising radiation based tool. CMR is
able to interrogate not only ventricular function and morphology but also characterise
the tissue itself on a scale validated with histology, investigate cellular function as well
as myocardial mechanics and energetics. Within this chapter we will summarise for the
reader the current use of CMR in heart failure, the emerging pulse sequences and the
state of the art application of CMR in specific settings within heart failure. CMR is
already proven to make significant clinical impact but challenges remain in harnessing
the wealth of information it can provide, proving the incremental value of each
technique and in widening the availability of CMR in order to maximise its benefit.
This chapter will provide an in-depth introduction to the topic, act as an update for the
more advanced practitioner and provide a platform for further interest and research.
Keywords: Acquired cardiomyopathy, cardiac magnetic resonance, cardiac
resynchronization, cardiac transplantation, diagnosis, dilated cardiomyopathy,
fibrosis, gadolinium, heart failure, imaging, inherited cardiomyopathy, ischaemic
heart disease, myocardial function, myocardial edema, myocardial
characterization, perfusion, prognosis, valvular heart disease.
