excellent for ventricular morphology and functional assessment and is currently the gold standard for both right and left ventricular (RV and LV) volumetric analysis and myocardial mass quantification. The hallmark of CMR is myocardial tissue characterization and gadolinium-enhanced images assist in characterization of myocardial pathology and help differentiate ischemic from nonischemic cardiomyopathy. CMR has a growing role in myocarditis and other infective and inflammatory cardiomyopathies.

In ischemic myocardial involvement, CMR has amongst the highest sensitivity and specificity to answer the 3 critical questions of cardiac function, perfusion and viability for risk stratification, management and prognostication of these patients. In hypertrophic cardiomyopathy, CMR enables accurate LV mass assessment and detailed characterization of HCM phenotype including atypical forms. Myocardial fibrosis detected on CMR has a clinical significance and may reclassify risk prediction and management.

The superior myocardial tissue characterization makes it extremely sensitive in the detection of amyloidosis, noncompaction, arrhythmogenic RV cardiomyopathy and other  cardiomyopathies.

Preablation CMR assessment is extremely useful in localization and characterization of myocardial scars, prediction of successful ablation sites and reduction of procedure and fluoroscopy times.