Over the past 2 decades, cardiac magnetic resonance (CMR) has become an essential component of cardiovascular clinical care and contributed to imaging-guided diagnosis and management of coronary artery disease, cardiomyopathy, congenital heart disease, cardio-oncology, valvular, and vascular disease, amongst others. The widespread availability, safety, and capability of CMR to provide corresponding anatomical, physiological, and functional data in 1 imaging session can improve the design and conduct of clinical trials through both a reduction of sample size and provision of important mechanistic data that may augment clinical trial findings. Moreover, prospective imaging-guided strategies using CMR can enhance safety, efficacy, and cost-effectiveness of cardiovascular pathways in clinical practice around the world. As the future of large-scale clinical trial design evolves to integrate personalized medicine, cost-effectiveness, and mechanistic insights of novel therapies, the integration of CMR will continue to play a critical role. In this document, the attributes, limitations, and challenges of CMR’s integration into the future design and conduct of clinical trials will also be covered, and recommendations for trialists will be explored. Several prominent examples of clinical trials that test the efficacy of CMR-imaging guided pathways will also be discussed.

在过去的 2 年里，心脏磁共振 (CMR) 已成为心血管临床护理的重要组成部分，并有助于冠状动脉疾病、心肌病、先天性心脏病、心脏肿瘤学、瓣膜和血管疾病的影像学引导诊断和管理， 在其他人中。CMR 的广泛可用性、安全性和在 1 个成像会话中提供相应的解剖、生理和功能数据的能力可以通过减少样本量和提供可能增强临床的重要机械数据来改进临床试验的设计和实施试验结果。此外，使用 CMR 的前瞻性成像引导策略可以提高全球临床实践中心血管通路的安全性、有效性和成本效益。随着大规模临床试验设计的未来演变为整合个性化医疗、成本效益和新疗法的机制见解，CMR 的整合将继续发挥关键作用。在本文件中，还将涵盖将 CMR 整合到未来临床试验设计和实施中的属性、局限性和挑战，并将探讨对试验者的建议。还将讨论测试 CMR 成像引导路径功效的临床试验的几个突出示例。还将涵盖 CMR 融入未来临床试验设计和实施的挑战，并将探讨对试验者的建议。还将讨论测试 CMR 成像引导路径功效的临床试验的几个突出示例。还将涵盖 CMR 融入未来临床试验设计和实施的挑战，并将探讨对试验者的建议。还将讨论测试 CMR 成像引导路径功效的临床试验的几个突出示例。