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Advances in cardiac magnetic resonance imaging of cardiomyopathy associated with metabolic abnormalities
HU Min  LI Bowen  SONG Zhengwu  YUAN Shouhong  SHAO Juwei 

DOI:10.12015/issn.1674-8034.2025.08.029.


[Abstract] The precision non-invasive early diagnosis of metabolic cardiomyopathy remains a significantly challenging, primarily due to its heterogeneous etiologies. Crucially, myocardial injury in these diseases emerges during early metabolic dysregulation, preceding detectable structural or functional abnormalities. Cardiac magnetic resonance (CMR), recognized as the gold standard for assessing cardiac structure and function, leverages its robust multiparametric imaging capabilities. Through integration of multiplanar, multisequence, and multi-axial scanning protocols, CMR not only delivers precise evaluation of cardiac morphology and function but also enables deep tissue characterization, indirectly capturing alterations in myocardial energy metabolism and biomechanical properties. This provides a multidimensional diagnostic framework for early detection of metabolic cardiomyopathy. This article systematically reviews the typical CMR manifestations of various metabolic abnormality-related cardiomyopathies, and points out that CMR has deficiencies such as the lack of standardization in the assessment of metabolic abnormality-related cardiomyopathies and the absence of specific imaging biomarkers that directly reflect myocardial metabolic disorders. Based on the analysis of the advantages and limitations of existing CMR, this article believes that future research should focus on key technological innovations, promoting multimodal image fusion, and establishing a standardized CMR diagnostic system, etc. This article aims to provide new research ideas for the pathogenesis, early diagnosis, subtype differentiation, and prognosis assessment of metabolic abnormality-related cardiomyopathies, and to provide a systematic reference.
[Keywords] cardiac magnetic resonance；diabetic cardiomyopathy；obese cardiomyopathy；iron overload cardiomyopathy；cardiac amyloidosis；fabry disease；Danon disease

HU Min1   LI Bowen2   SONG Zhengwu2   YUAN Shouhong2   SHAO Juwei2*  

1 College of Clinical Medicine, Dali University, Dali 671003, China

2 Department of Radiology, the Affiliated Hospital of Yunnan University, Kunming 650021, China

Corresponding author: SHAO J W, E-mail: wavevivi@163.com

Conflicts of interest   None.

Received  2025-06-02
Accepted  2025-08-05
DOI: 10.12015/issn.1674-8034.2025.08.029
DOI:10.12015/issn.1674-8034.2025.08.029.

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