Cardiovascular magnetic resonance using late gadolinium enhancement (LGE) provides a unique opportunity to assess myocardial tissue in vivo. LGE enables tissue characterization in ischemic and nonischemic cardiomyopathies and other cardiac diseases. LGE is associated with adverse clinical outcomes across a range of different cardiac conditions and may improve risk stratification for death, sudden cardiac death, or serious adverse events beyond traditional prognostic markers. Generally, matching data for the prognostic impact of LGE are frequently reached in cardiac disorders. In other diseases, only a limited number of trials are available, but it is anticipated that the prognostic impact of delayed enhancement will become evident. The development and validation of new cardiovascular magnetic resonance methods for diffuse myocardial fibrosis measurements would even improve the prognostic impact of LGE. The evaluation of diffuse myocardial fibrosis has a great potential in large-scale diseases, including their initial phases, with the possibility to identify patients at risk for subsequent development of clinical heart failure, to assess repeatedly the stage and progression of cardiac diseases, and to monitor the effect of treatment.

From the *Department of Cardiovascular Diseases International Clinical Research Center St Anne's Faculty Hospital and Masaryk University Brno Czech Republic; †Department of Interventional Radiology Hospital Trinec Podlesi Trinec Czech Republic; ‡Department of Medical Imaging St Anne's Hospital Masaryk University Brno Czech Republic; and §Institute of Normal and Pathological Physiology and Center of Excellence for Regulatory Role of Nitric Oxide in Civilization Diseases Slovak Academy of Sciences Bratislava Slovak Republic

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