When the history of medicine in the latter half of the twentieth century is written, the advances in cardiovascular diagnosis, therapy, and prevention will stand out as one of the most important achievements. Although the age-corrected death rate secondary to coronary artery disease has declined substantially in industri- ized nations during this period, the prevalence of these conditions remains stubbornly high because of the aging of the population. Importantly, the incidence of coronary events and of one of their most important sequelae—heart failure—is rising ala- ingly in the developing world. When viewed from a global perspective, cardiovascular disease is assuming a progressively greater importance, and it is estimated that by 2025 it will be, for the ? rst time in human history, the most common cause of death. Clearly, rather than resting on the laurels of our achievements, an intensi? cation of the battle against cardiovascular disease must now be undertaken. Cardiovascular imaging will, without question, play a critical role in this battle. The appropriate sel- tion of therapeutic measures, be they pharmacologic, catheter-based, surgical, alte- tions in lifestyles, or some combination of these, depends on accurate assessments of both cardiac structure and function. Increasingly, the changes that dictate mana- ment are quite subtle and require a level of precision that was not available to cli- cians heretofore.