Multimodality Imaging for Cardiomyopathies in the Era of Precision Medicine

Abstract

A clinical approach to new cardiomyopathy entails defining patient phenotype and disease pathophysiology. After echocardiography, invasive assessments to define hemodynamics and coronary anatomy are usually pursued. In selected non-ischemic cases, endomyocardial biopsies are performed in search for an etiology. Fortunately, advances in cardiac imaging allow for a multifaceted cardiac evaluation in a single study, reducing cost, lead time to diagnosis, and procedural adverse events while still providing supreme accuracy. As the stream of science and clinical practice worldwide emphasizes personalized and high-value care, noninvasive imaging has emerged as a new standard to prevent, diagnose, and guide the treatment of cardiac disease, reserving invasive procedures to cases where an intervention is required. Given their versatility and precision compared to nuclear imaging and echocardiography, we elected to focus on computed tomography (CT) and cardiac magnetic resonance (CMR) in this monograph. Given the many etiologies and phenotypes of heart disease, the most