Magnetic resonance in the cardiovascular diseases – the great diagnostic challenge of 21st century

Cardiovascular diseases (CVD) are the leading cause of death in the world as well as in our country. Most CVD could be prevented by correcting behavioural and environmental risk factors such as tobacco use, reduction of weight, harmful use of alcohol and air pollution, but also by increasing physical activity1. Patients with chronic kidney disease (CKD) have an elevated cardiovascular risk that presents as coronary artery disease, heart failure, arrhythmias, and sudden cardiac death2. The incidence of morbidity and mortality in dialysis patients is greater than in the general population. Arrhythmia/cardiac arrest alone is the cause of death in 40% of dialysis patients2. CKD causes a systemic, chronic pro-inflammatory state leading to vascular and myocardial remodeling processes resulting in atherosclerotic lesions, vascular and valvular calcifications as well as myocardial fibrosis3. Cardiac fibrosis in patients with CKD is characterized by diffuse collagen deposition between capillaries and cardiomyocytes funneling into the maladaptive ventricular hypertrophy with subsequent dilatation of the heart.