Phenotyping heart failure by echocardiography: Imaging of ventricular function and haemodynamics at rest and exercise - Archive ouverte HAL Accéder directement au contenu
Article Dans Une Revue European Heart Journal - Cardiovascular Imaging Année : 2023

Phenotyping heart failure by echocardiography: Imaging of ventricular function and haemodynamics at rest and exercise

Résumé

Traditionally, congestive heart failure was phenotyped by echocardiography or other imaging techniques according to left ventricular ejection fraction (LVEF). The more recent echocardiographic modality speckle tracking strain is complementary to LVEF, as it is more sensitive to diagnose mild systolic dysfunction. Furthermore, when LV systolic dysfunction is associated with a small, hypertrophic ventricle, EF is often normal or supernormal, whereas LV global longitudinal strain can reveal reduced contractility. In addition, segmental strain patterns may be used to identify specific cardiomyopathies which in some cases can be treated with patient-specific medicine. In heart failure with preserved LVEF (HFpEF), a diagnostic hallmark is elevated LV filling pressure, which can be diagnosed with good accuracy by applying a set of echocardiographic parameters. When patients with HFpEF often have normal filling pressure at rest, a non-invasive or invasive diastolic stress test may be used to identify abnormal elevation of filling pressure during exercise. The novel parameter LV work index which incorporates afterload, is a promising tool for quantification of LV contractile function and efficiency. Another novel modality is shear wave imaging for diagnosing stiff ventricles, but clinical utility remains to be determined. In conclusion, echocardiographic imaging of cardiac function should include LV strain as a supplementary method to LVEF. Echocardiographic parameters can identify elevated LV filling pressure with good accuracy and may be applied in the diagnostic work-up of patients suspected of HFpEF.
Fichier principal
Vignette du fichier
jead196.pdf (6.01 Mo) Télécharger le fichier
Origine : Fichiers éditeurs autorisés sur une archive ouverte

Dates et versions

hal-04196124 , version 1 (05-09-2023)

Licence

Paternité - Pas d'utilisation commerciale

Identifiants

Citer

Otto A Smiseth, Erwan Donal, Espen Boe, Jong-Won Ha, Joao F Fernandes, et al.. Phenotyping heart failure by echocardiography: Imaging of ventricular function and haemodynamics at rest and exercise. European Heart Journal - Cardiovascular Imaging, 2023, ⟨10.1093/ehjci/jead196⟩. ⟨hal-04196124⟩
22 Consultations
12 Téléchargements

Altmetric

Partager

Gmail Facebook X LinkedIn More