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Finding Cardiomyopathy phenotype Cardiac CMR examples Specific diseases to be considered Posterolateral LGE and concentric LVH Low native T1 Anderson–Fabry disease Amyloidosis Sarcomeric HCM Haemochromatosis Post-myocarditis Dystrophinopathy Sarcoidosis Chagas disease DSP variants FLNC variants DES variants Laminopathy Desmosomal variants EMF/hypereosinophilia Diffuse subendocardial LGE, high native T1 Patchy mid-wall in hypertrophied areas Short T2* Subepicardial LGE Lateral wall epicardial LGE Subepicardial and midwall LGE at basal septum +/- extension into inferolateral wall and RV insertion points Apical transmural LGE Ring-like and/or subepicardial LGE pattern Septal mid-wall LGE Fat and LGE (transmural RV plus sub-epicardial-midmural LV free wall) Partial LV or RV apical obliteration + LGE at endocardial level HCM DCM NDLVC ARVC RCM Figure 7 Examples of cardiac magnetic resonance imaging tissue characterization features that should raise the suspicion of specific aetiologies, grouped according to cardiomyopathy phenotype. ARVC, arrhythmogenic right ventricular cardiomyopathy; CMR, cardiac magnetic resonance; DCM, dilated cardiomyopathy; DES, desmin; DSP, desmoplakin; EMF, endomyocardial fibrosis; FLNC, filamin C; HCM, hypertrophic cardiomyopathy; LGE, late gadolinium enhancement; LV, left ventricular; LVH, left ventricular hypertrophy; NDLVC, non-dilated left ventricular cardiomyopathy; RCM, restrictive cardiomyopathy; RV, right ventricular. Examples of CMR tissue characterization features that should raise the suspicion of specific aetiologies (column 4), grouped according to cardiomyopathy phenotype (column 1). CMR images features (column 3) correspond to the listed findings (column 2).Image %: ESC Guidelines 3527 Downloaded from academic.oup.com/eurheartj/article/44/37/3503/7246608 by guest on 07 October 2026