Magnetic Resonance Diffusion Tensor Imaging Provides New Insights Into the Microstructural Alterations in Dilated Cardiomyopathy

Cardiac magnetic resonance (CMR) diffusion tensor imaging (DTI) is a promising technique capable of probing the myocardial microstructure by assessing the myofiber orientation.1,2 New technical developments in CMR DTI in recent years3–8 have allowed the clinical application of this powerful imaging technique. CMR DTI has been used to study myocardial infarction9,10 and hypertrophic cardiomyopathy11,12 in patients, revealing their adverse effects on myocardial microstructure. The article in this issue of Circulation: Cardiovascular Imaging by von Deuster et al13 describes a new clinical application of CMR DTI.See Article by von Deuster et al In this single-center study, von Deuster et al13 studied patients with dilated cardiomyopathy (DCM) using CMR DTI and assessed the change in the myocardial fiber orientation by imaging at 2 separate time points in the cardiac cycle. DCM is a major cause of heart failure that causes ventricular chamber enlargement, wall thinning, and systolic dysfunction. The authors hypothesized that a combination of CMR DTI, myocardial tagging, and biomechanical modeling will shed new insight into the alterations of myocardial microstructure and functional performance …