Dilated cardiomyopathy (DCM) is a heart muscle disorder that frequently leads to heart failure. It is defined by the presence of left ventricular (LV) dilatation and LV systolic dysfunction in the absence of abnormal loading conditions or extensive coronary artery disease (CAD).Â In that regard, the accurate and reproducible assessment of cardiac dimensions and function is paramount, but there is also a need to fully characterise valve function and the presence and functional consequences of CAD. This is particularly important because coronary heart disease is considered the most frequent cause for finding a dilated, dysfunctional heart in clinical practice. Also, LV enlargement and dysfunction are late features of chronic volume or pressure overload that are seen in patients with severe valve disease. Therefore, multimodality cardiac imaging aims to correctly identify DCM from the wider pool of patients with reduced ejection fraction (EF).