The Central Role of Cardiac MRI in the Management of Heart Failure and Cardiomyopathy Patients

Guest: Gosia Wamil, M.D., Ph.D. Host: Malcolm R. Bell, M.D. Cardiac MRI is now central to heart failure care, moving beyond imaging to guide diagnosis and treatment. It distinguishes disease causes, identifies fibrosis and scar, and uncovers specific conditions in both HFrEF and HFpEF. By providing prognostic markers, it helps tailor therapies and improve outcomes—delivering the right treatment at the right time. In this episode of "Interviews With the Experts," Dr. Malcolm Bell interviews Dr. Gosia Wamil from Mayo Clinic London practice on the role of cardiac MRI in practice. Topics Discussed: • When does CMR change the management decision? • CMR findings • Which CMR biomarkers truly predict outcomes—and how should clinicians act on them? • From echo-first to CMR-led pathways: what should every HF service implement now? 00:00 Introduction 01:01 Why Cardiac MRI Is Transforming Heart Failure Care 03:07 Diagnosing Cardiomyopathies with Cardiac MRI 05:01 MRI vs Echocardiography: What's the Difference? 06:15 Scar Imaging, Tissue Characterization and ECV Mapping 09:26 Cardiac MRI After a Heart Attack 12:43 Can MRI Replace Other Cardiac Tests? 14:05 Precision Medicine and Deep Phenotyping 15:50 How MRI Changes Treatment Decisions 18:10 Final Takeaways