The appearance of LGE is caused by prolonged, interstitial contrast-agent deposition used for CMR image acquisition. LGE is known to accurately delineate scarring following myocardial infarction. In contrast, the diagnostic accuracy is less defined in other cardiac diseases. Intramyocardial, often distributed, spots of LGE are typically found in myocarditis, although the finding is neither obligatory nor specific. Additional sequences (eg, edema sensitive) are required for further classification.2 In dilated cardiomyopathy, LGE frequently occurs as a septal midwall pattern or at the hinge points of the septum. It has been deduced from postinfarct findings that LGE also would delineate fibrosis in dilated cardiomyopathy, which remains debatable. Studies on histology showed that the extent of myocardial fibrosis involves a gradient that increases from subepicardial to subendocardial layers not matching a midwall pattern. Due to the increased load of the affected regions, the question arises whether functional determinants are involved.