Cardiac magnetic resonance imaging (CMRI) has been under development for the past four decades and has more recently become an essential tool in the evaluation of ischemic heart disease (IHD). It is the reference standard for quantification of both right and left ventricular volume and function and, after landmark work published in the New England Journal of Medicine in 2000, has proven effective in identifying hibernating myocardium, or hypokinetic myocardium that will recover after revascularization. More recent literature continues to support both delayed enhancement imaging and CMRI stress perfusion as essential tools in evaluating IHD. This review will briefly address the basics of CMRI and the scientific literature supporting the use of CMRI in IHD. It will then address more recent clinical studies establishing the clinical utility of CMRI in IHD, followed by a discussion of future directions in CMRI.
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