CMR in hypertrophic cardiac conditions—an update

Purpose of Review: Myocardial left ventricular (LV) hypertrophy (LVH) is a common phenotype associated to increased morbidity and mortality. Beyond an accurate LV mass quantification, cardiovascular magnetic resonance (CMR) can also provide tissue characterization, perfusion, and deformation assessments. Aim of the present review is to discuss recent advances in CMR imaging of LVH. Recent Findings: T1 and T2 mapping techniques expanded the ability of CMR in phenotyping LVH, underscoring the pathogenic significance of interstitial fibrosis and edema in hypertrophic conditions. Perfusion and deformation assessments revealed dysfunctional correlates not uncommonly associated to LVH. Late gadolinium enhancement (LGE) highlighted the role of replacement fibrosis as a marker of advanced disease. Finally, the prognostic relevance of both interstitial and replacement fibrosis has been demonstrated in several LVH conditions. Summary: CMR is an efficient tool for differential diagnosis of LVH phenotypes. Furthermore, it can often provide prognostic information, potentially guiding treatment and improving clinical management.