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New perspectives in the echocardiographic hemodynamics multiparametric assessment of patients with heart failure
Department of Cardiovascular Disease–AUSL Romagna, Division of Cardiology, Ospedale S. Maria delle Croci, Viale Randi 5, Ravenna, Italy.
Department of Cardiovascular Disease–AUSL Romagna, Division of Cardiology, Ospedale S. Maria delle Croci, Viale Randi 5, Ravenna, Italy.
Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy.
Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy.
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2024 (English)In: Heart Failure Reviews, ISSN 1382-4147, E-ISSN 1573-7322, Vol. 29, no 4, p. 799-809Article, review/survey (Refereed) Published
Abstract [en]

International Guidelines consider left ventricular ejection fraction (LVEF) as an important parameter to categorize patients with heart failure (HF) and to define recommended treatments in clinical practice. However, LVEF has some technical and clinical limitations, being derived from geometric assumptions and is unable to evaluate intrinsic myocardial function and LV filling pressure (LVFP). Moreover, it has been shown to fail to predict clinical outcome in patients with end-stage HF. The analysis of LV antegrade flow derived from pulsed-wave Doppler (stroke volume index, stroke distance, cardiac output, and cardiac index) and non-invasive evaluation of LVFP have demonstrated some advantages and prognostic implications in HF patients. Speckle tracking echocardiography (STE) is able to unmask intrinsic myocardial systolic dysfunction in HF patients, particularly in those with LV preserved EF, hence allowing analysis of LV, right ventricular and left atrial (LA) intrinsic myocardial function (global peak atrial LS, (PALS)). Global PALS has been proven a reliable index of LVFP which could fill the gaps "gray zone" in the previous Guidelines algorithm for the assessment of LV diastolic dysfunction and LVFP, being added to the latest European Association of Cardiovascular Imaging Consensus document for the use of multimodality imaging in evaluating HFpEF. The aim of this review is to highlight the importance of the hemodynamics multiparametric approach of assessing myocardial function (from LVFP to stroke volume) in patients with HF, thus overcoming the limitations of LVEF.

Place, publisher, year, edition, pages
Springer, 2024. Vol. 29, no 4, p. 799-809
Keywords [en]
Diagnosis, Echocardiography, Heart failure, Hemodynamics, Prognosis, Stroke volume
National Category
Cardiac and Cardiovascular Systems
Identifiers
URN: urn:nbn:se:umu:diva-223236DOI: 10.1007/s10741-024-10398-7ISI: 001187208500001PubMedID: 38507022Scopus ID: 2-s2.0-85188188643OAI: oai:DiVA.org:umu-223236DiVA, id: diva2:1852783
Available from: 2024-04-19 Created: 2024-04-19 Last updated: 2024-07-15Bibliographically approved

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Henein, Michael Y.

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