Chronic heart failure is a common disorder placing significant burdens on patients and health-care services. Noninvasive imaging plays a central role in accurate diagnosis, determination of etiology and prognosis, and in monitoring therapy. Advances in technology mean cardiovascular magnetic resonance (CMR) imaging has established itself as both a valuable clinical and research tool in this arena. Not only is CMR the new gold standard for accurate and reproducible assessment of ventricular volumes and mass, but by using gadolinium contrast, underlying pathology can often be determined. In ischemic cardiomyopathy a 'one stop' assessment can be made of function, perfusion and mass. Continuing advances such as myocardial tagging and the increasing availability of CMR mean that it will become an increasingly important and useful tool for clinicians looking after patients with cardiomyopathy and heart failure.
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