The Contemporary Role of Cardiovascular Magnetic Resonance in Ischemic Cardiomyopathy

Ischemic cardiomyopathy is the leading cause of heart failure globally. While echocardiography is the cornerstone of cardiovascular imaging, cardiovascular magnetic resonance (CMR) plays a crucial role in providing a thorough assessment of both cardiac structure and function. CMR can deliver accurate information on cardiac function, perfusion, and tissue characterization, all while avoiding ionizing radiation and overcoming challenges associated with imaging window quality. Across the different stages of ischemic heart disease, CMR provides a precise assessment of infarct age, size, and related complications, while also supporting treatment decisions and predicting recovery. This review emphasizes not only the established diagnostic and prognostic roles of CMR in ischemic cardiomyopathy but also explores emerging quantitative and artificial intelligence-based approaches poised to redefine clinical practice.