MRI of the heart for the assessment of structural and functional changes in the myocardium in patients with chronic heart failure

Chronic heart failure (CHF) is a severe clinical syndrome, which can develop in patients with various heart diseases. Tactics of management of patients with CHF depends on cause of development of this syndrome, therefore exact diagnosis is especially important. Echocardiography (EchoCG) is the main method in algorithm of examination with any cardiological examination, but neither EchoCG, nor other traditional cardiological methods of examination in all clinical situations can reveal cause of development of CHF, therefore search for new diagnostic strategies is important. Objective of the work: to show possibilities of magnetic resonance tomography of heart in examination of patients with chronic heart failure on example of own clinical observations. Materials and methods. Analyzed heart studies performed on patients with chronic heart failure from March 2024 to December 2025. An analysis of the literature devoted to the diagnosis of chronic heart failure was conducted, and the search was carried out using the Google Scholar, Scopus, PubMed, and Web of Science databases. All clinical cases presented in the article were performed by the authors of the article. Results. Along with traditional methods of cardio-visualization (EchoCG, scintigraphy of myocardium), MRI with contrast agent is included in diagnostic algorithm of examination of patients with chronic heart failure, especially in complex situations. The article presents standard protocols of MRI for analysis of structural and functional changes of myocardium, contraindications to performance of MRI. On clinical observations possibilities of MRI are demonstrated in clarification of etiology of chronic heart failure in patients with reduced ejection fraction and preserved ejection fraction of left ventricle. Presented clinical cases of use of MRI for differential diagnosis of various causes of hypertrophy of myocardium of LV in patients with CHF, differential diagnosis of ischemic and non-ischemic lesion of myocardium. Conclusion. In the work are demonstrated the possibilities magnetic resonance tomography is highly informative method of diagnosis in patients with chronic heart failure, both in patients with reduced ejection fraction and in absence of its reduction.