Other considerations The committee considered the use of cardiac MRI in heart failure to be an area of high priority for future research. While cardiac MRI is being increasingly used in heart failure in the UK, there remains large variation in practice across the country, and significant equality issues around access (for example, based on age and geography). There are also significant cost and resource implications. The committee discussed an existing clinical trial that is currently underway ), which will compare outcomes in patients randomised to either routine cardiac MRI or selective (clinically driven) cardiac MRI. The trial is recruiting patients with heart failure and a working clinical diagnosis of non-ischaemic cardiomyopathy and patients with heart failure with preserved ejection fraction. The committee considered that the results of this trial would be very useful in answering the question posed in this review, but noted that it would not answer a number of the questions of interest, namely: the clinical and cost effectiveness of adding cardiac MRI (either routinely or selectively) to echocardiography in all patients with HFREF For those reasons, notwithstanding the trial presently underway, the committee decided to make a research recommendation to establish the added value of cardiac MRI (in terms of its clinical and cost effectiveness) in all patients with heart failure. The committee also discussed the following proposed review question in the guideline scope: What is the role of secondary imaging investigations in Chronic Heart Failure Diagnosing heart failure NICE 2018. All rights reserved. Subject to Notice of rights. ISBN: 978-1-4731-3093-7 diagnosing suspected amyloidosis? The original objective of this question was to see if various imaging techniques (including cardiac MRI and bone scintigraphy using DPD tracing), when used following echocardiography, could identify a particular subset of people with HFPEF caused by amyloidosis. 