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Prognostic importance of late gadolinium enhancement cardiovascular magnetic resonance in cardiomyopathy
  1. Tevfik F Ismail,
  2. Sanjay K Prasad,
  3. Dudley J Pennell
  1. CMR Unit, Royal Brompton Hospital, London, UK
  1. Correspondence to Professor Dudley J Pennell, CMR Unit, Royal Brompton Hospital, Sydney Street, London SW3 6NP, UK; d.pennell{at}


Cardiovascular magnetic resonance has revolutionised the diagnosis of cardiomyopathy, particularly through the use of late gadolinium enhancement imaging which provides the unique opportunity to assess myocardial fibrosis in vivo. More recently, the prognostic capability of cardiovascular magnetic resonance to predict outcomes has been assessed. Traditional risk markers do not at present adequately predict outcomes in either dilated cardiomyopathy or hypertrophic cardiomyopathy, which are the two most common causes of primary heart muscle disease. Many of these existing markers reflect underlying disease severity. Given the important role fibrosis is thought to play in the pathogenesis and sequelae of these cardiomyopathies, the presence and amount of fibrosis has been proposed as a potential novel risk factor for adverse events. This paper reviews the evidence for late gadolinium enhancement as a prognostic marker in dilated and hypertrophic cardiomyopathy and highlights the challenges ahead.

  • CMR
  • myocardial fibrosis
  • hypertrophic cardiomyopathy
  • dilated cardiomyopathy
  • sudden cardiac death
  • cardiomyopathy hypertrophic
  • ventricular hypertrophy
  • myocardial perfusion
  • MRI
  • heart failure
  • EBM
  • cardiac imaging
  • congestive heart failure

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  • Funding This work is supported by the NIHR Cardiovascular Biomedical Research Unit at Royal Brompton and Harefield NHS Foundation Trust, and Imperial College. TFI is supported by the British Heart Foundation.

  • Competing interests None.

  • Provenance and peer review Commissioned; externally peer reviewed.