The Future Role, Clinical and Economic Implications of Cardiac Magnetic Resonance (CMR) Imaging in Non-Ischemic Dilated Cardiomyopathy

Malka Yahalom and Yoav Turgeman

The use of cardiovascular magnetic resonance (CMR) imaging for assessing and evaluating cardiovascular pathologies is growing rapidly. This non-invasive, non-ionizing technology has multiple advantages compared with the X-ray or gamma ray derived technologies. For instance, CMR is a non-invasive and sensitive tool for detecting islands of fibrosis. Cardiac fibrosis may occur in both ischemic and non-ischemic cardiac pathologies.This finding has a negative impact on sudden cardiac arrhythmic death. A correlation has been found between CMR data and histo-pathologic findings. The presence of this pathology among normal looking fibers indicates the presence of non-functional areas that may evoke malignant arrhythmia, and contribute to deterioration in cardiac mechanical function. By using this non-invasive modality, the role of cardiac fibrosis as a potential source for cardiac arrhythmia and or LV dysfunction can be better evaluated and managed. This finding may serve as a useful tool for risk stratification of patients with borderline indication for primary AICD implantation.