# Clinical application of cardiac computed tomography in cardiomyopathy

## TL;DR

This paper reviews how cardiac computed tomography is becoming a useful alternative to magnetic resonance imaging for diagnosing cardiomyopathies.

## Contribution

The paper highlights the expanding clinical role of cardiac computed tomography in cardiomyopathy evaluation.

## Key findings

- CCT provides detailed anatomical, functional, and tissue-specific insights.
- CCT is a valuable alternative when cardiovascular magnetic resonance is not feasible.
- Emerging technologies like AI may enhance CCT's diagnostic value.

## Abstract

Cardiomyopathies are a heterogeneous group of myocardial disorders characterized by mechanical and/or electrical dysfunction, typically occurring without significant coronary artery disease, hypertension, valvular, or congenital heart disease. According to current ESC guidelines, cardiovascular magnetic resonance (CMR) is a class I recommendation for the initial evaluation of patients with suspected cardiomyopathy, given its ability to provide comprehensive morphological and tissue characterization. CMR, however, may be precluded in patients owing to device incompatibility, claustrophobia, or arrhythmia- and motion-related image degradation. In this context, cardiac computed tomography (CCT), traditionally used for assessing coronary artery disease, has emerged as a valuable alternative. Technological advancements have enabled CCT to deliver not only detailed anatomical information but also functional and tissue-specific insights. The recent consensus document from the European Association of Cardiovascular Imaging underscore the expanding clinical applications of CCT, highlighting its potential role in the diagnostic work-up and phenotypic classification of cardiomyopathies. In this review, we summarize the current evidence supporting the use of CCT in patients with suspected cardiomyopathy, outline its clinical strengths and limitations, and discuss emerging developments such as artificial intelligence and radiomics, which could further enhance its diagnostic and prognostic value.

Cardiac computed tomographyis an emerging alternative to CMR, offering comprehensive anatomical, functional, and tissue characterization in suspectedcardiomyopathies

Cardiac computed tomographyis an emerging alternative to CMR, offering comprehensive anatomical, functional, and tissue characterization in suspectedcardiomyopathies