Table 2.

Main diagnostic and prognostic CMR findings in CMPs with dilatative and hypertrophic phenotype

	Dilatative phenotipe			Hypertrophic phenotipe
	DCM	ACM	Myocarditis	HCM	AFD	Amyloidosis
Diagnosis	Cine imaging: reduced left/biventricular systolic function, possible left/bi ventricular dilatation T2 weighted imaging: differential diagnosis from “acute inflammatory” cardiomyopathies LGE: in up to 30–40% of cases, typically midwall pattern in the interventricular septum. Other patterns are possible (subepicardial pattern in post inflammatory DCM) Mapping: altered T1 and ECV mapping reflecting the presence of interstitial fibrosis Feature tracking analysis: may be more accurate in the detection of impaired contractility	Cine with additional sequences for right ventricle: RV or biventricular morpho-functional abnormalities Detection of fatty infiltration from “India-Ink” artifact T2 weighted imaging: in case of “hot-phases” presentation; differential diagnosis from “acute inflammatory” cardiomyopathies FSE: fatty infiltration of the RV and/or LV (might be replaced by the assessment of “India Ink” artifact from SSFP) LGE: detection of areas of fibro fatty myocardial replacement. Commonly in the subepicardial layers of the LV free wall, expecially in the inferolateral region, with or without septal involvement. Possible LGE “ring pattern” in some left dominant variants Mapping: still limited applications Feature tracking analysis: could allow the detection of segmental impairment of wall contraction in early phases	Cine imaging: detection of ventricular systolic dysfunction, and impaired contractility Detection of hyperemia when acquired immediately after Gd injection T2 weighted imaging: detection of edema in the acute phase LGE: detection of necrosis (acute phase)/ fibrosis (healed myocarditis) Mapping: increased T1 mapping/ECV values in both acute and chronic forms, altered T2 mapping values in the acute phase Feature tracking analysis: may be more accurate in the detection of impaired contractility	Cine imaging: assessment of ventricular mass, chamber volume, cardiac function, pattern and distribution of hypertrophy. Detection of right ventricular as well as papillary muscles hypertrophy In genotype positive phenotype negative subjects: detection of myocardial crypts, elongated anterior mitral leaflet, abnormal apical trabeculae and smaller LV ventricular volumes Special sequencese for the evaluation of LVOT obstruction T2 weighted imaging: detection of oedema/ongoing interstitial remodelling LGE: found in up to 80% of HCM population Mapping: altered T1 and ECV mapping reflecting the presence of interstitial fibrosis	Cine imaging: assessment of ventricular mass, chamber volume, cardiac function, pattern and distribution of hypertrophy (Typically concentric) LGE: typically with non-ischemic mid wall or subepicardial pattern, mainly involving the basal, inferolateral LV segment Mapping: reduction in native T1 in the early phase of the disease with following pseudo normalization. Normal ECV values	Cine imaging: assessment of ventricular mass, chamber volume, cardiac function LGE: diffuse subendocardial LGE (highly specific for CA). Difficult myocardial nulling TI scout: useful to detect a very short myocardial nulling time (before or close to the bloodpool), typical of advanced forms of cardiac amyloidosis Mapping: high T1 values for non-contrast diagnosis; high ECV values, parameter with best diagnostic accuracy
Prognosis	Cine imaging: detection and assessment of right ventricular dysfunction LGE: predictor of adversed prognosis. The impact of LGE extension as well as the role of the different LGE locations are still debated Feature tracking analysis: reduced GLS was could correlate with a worse outcome, still needs validation Mapping: altered T1 and ECV mapping predictors of adverse prognosis in small studies	Cine imaging: assessment of biventricular dysfunction LGE: the prognostic impact of LGE extension and location are still debated	T2 weighted imaging: abnormal findings correlate with a worse outcome LGE: negative prognostic value especially if located in the interventricular septum Feature tracking analysis: reduced GLS may correlate with a worse outcome, still under evaluation	LGE: the presence of a total LGE of more than 10–15% of LV mass correlates with increased risk of SCD Mapping / dimensions phase contrast CMR (4D flow/ dispersion map of LGE/ Contrast-enhanced CMR: under evaluation		LGE: independent predictor of mortality, especially when transmural Mapping: ECV values are the best parameter to predict patients’ prognosis

In Italics are highlighted the optional techniques