Identifying the Etiology: A Systematic Approach Using Delayed-Enhancement Cardiovascular Magnetic Resonance

Annamalai Senthilkumar, Maulik D. Majmudar, Chetan Shenoy, Han W. Kim, Raymond J. Kim

Research output: Contribution to journalReview articlepeer-review

34 Scopus citations


In patients who have heart failure, treatment and survival are directly related to the cause. Clinically, as a practical first step, patients are classified as having either ischemic or non-ischemic cardiomyopathy, a delineation usually based on the presence or absence of epicardial coronary artery disease. However, this approach does not account for patients with non-ischemic cardiomyopathy who also have coronary artery disease, which may be either incidental or partly contributing to myocardial dysfunction (mixed cardiomyopathy). By allowing direct assessment of the myocardium, delayed-enhancement cardiovascular magnetic resonance (DE-CMR) may aid in addressing these conundrums. This article explores the use of DE-CMR in identifying ischemic and non-ischemic myopathic processes and details a systematic approach to determine the cause of cardiomyopathy.

Original languageEnglish (US)
Pages (from-to)349-367
Number of pages19
JournalHeart Failure Clinics
Issue number3
StatePublished - Jul 2009

Bibliographical note

Funding Information:
This work was supported in part by National Institutes of Health Grant RO1-HL64726 (RJK).


  • Cardiomyopathy
  • Cardiovascular magnetic resonance
  • Delayed enhancement imaging
  • Heart failure
  • Ischemic
  • Non-ischemic

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