Introduction : Heart failure is a common condition, and is associated with increased morbidity and mortality.Left ventricular (LV) systolic dysfunction is a significant cause of heart failure.Accurate diagnosis of the etiology for LV systolic dysfunction is important for prognostication and therapy.Cardiovascular magnetic resonance imaging (CMR) is now the gold standard for the evaluation of ventricular volumes and function.It is increasingly utilized as a diagnostic tool in patients presenting with LV systolic dysfunction.We aim to evaluate the etiology for left ventricular (LV) systolic dysfunction in patients presenting for CMR.