Cardiac magnetic resonance biomarkers as surrogate endpoints in cardiovascular trials for myocardial diseases

Eur Heart J. 2023 Dec 1;44(45):4738-4747. doi: 10.1093/eurheartj/ehad510.


Cardiac magnetic resonance offers multiple facets in the diagnosis, risk stratification, and management of patients with myocardial diseases. Particularly, its feature to precisely monitor disease activity lends itself to quantify response to novel therapeutics. This review critically appraises the value of cardiac magnetic resonance imaging biomarkers as surrogate endpoints for prospective clinical trials. The primary focus is to comprehensively outline the value of established cardiac magnetic resonance parameters in myocardial diseases. These include heart failure, cardiac amyloidosis, iron overload cardiomyopathy, hypertrophic cardiomyopathy, cardio-oncology, and inflammatory cardiomyopathies like myocarditis and sarcoidosis.

Keywords: Biomarker; CMR; Clinical trial; Echocardiography; Imaging; PET.

Publication types

  • Review

MeSH terms

  • Biomarkers
  • Cardiomyopathies* / diagnostic imaging
  • Humans
  • Magnetic Resonance Imaging / methods
  • Magnetic Resonance Spectroscopy
  • Myocarditis* / diagnosis
  • Prospective Studies


  • Biomarkers