[2010] 5.4.2 Heart failure caused by valve disease 15.Refer people with heart failure caused by valve disease for specialist assessment and advice regarding follow-up. [2003] 5.4.3 Reviewing existing diagnoses 16.Review the basis for a historical diagnosis of heart failure, and manage care in accordance with this guideline only if the diagnosis is confirmed. [2003] 17.If the diagnosis of heart failure is still suspected, but confirmation of the underlying cardiac abnormality has not occurred, then the person should have appropriate further Chronic Heart Failure Diagnosing heart failure NICE 2018. All rights reserved. Subject to Notice of rights. ISBN: 978-1-4731-3093-7 5.5 Cardiac Magnetic Resonance Imaging (cMRI) Cardiac magnetic resonance imaging (cMRI) provides accurate and reproducible assessments of the systolic function of the ventricles, and some assessment of diastolic function of the ventricles. It is capable of studying the myocardial perfusion, infiltration and cardiac involvement by oedema, inflammation and scarring. cMRI provides an accurate assessment of the iron content of the myocardium. Using special sequences, cMRI is also capable of assessing ischaemia and scarring without the use of contrast media. cMRI is also capable of assessing valve lesions and shunts as well as measuring cardiac muscle mass and chamber volume. In chronic heart failure, cMRI is currently used in some centres for the assessment of left ventricular ejection fraction, the assessment of myocardial ischaemia, and for the detection and characterisation of myocardial scarring, inflammation or infiltration. There has been a rapid expansion in the number of cardiac magnetic resonance imaging (CMR) tests performed in the UK from 20597 in 2008 to 38485 in 2010 and yet there are no clear recommendations about its use. 