Echocardiography in the Management of Patients with Heart Failure

Echocardiography is a valuable diagnostic tool for the management of heart failure (HF), by demonstrating structural and functional abnormalities in individuals characterized by increased risk of developing HF, patients with clinical features indicating HF, or cases of symptomatic HF. Echocardiography evaluates cardiac structural and functional parameters, having an important role in investigating the aetiology of heart conditions and providing prognostic information. During past years, two-dimensional echocardiography has been a valuable technique because of its ability to provide reliable diagnostic and prognostic information in HF patients. On the other hand, Doppler ultrasound, as a non-invasive tool, contributes to the identification of systolic and diastolic dysfunction. In clinical trials, the predictive value of ejection fraction has been consistently demonstrated; lower ejection fraction has been related to higher risk of cardiac death. Although a normal left ventricular function is observed in 40–50% of HF patients based on the results of recent clinical trials, the development of a global parameter, reflecting the remodelling process and functional abnormalities, is required. In this regard, recently developed three-dimensional volumetric measures of left ventricular anatomy and function seem very promising; however, more trials should be performed for further validation. Echocardiographic evaluation is considered as an essential part of HF management, despite the fact that no single examination meets all imaging requirements for HF investigation. Other modalities can provide additional evidence regarding specific questions, such as tissue characterization.

Keywords: 2D echocardiography, 3D echocardiography, Cardiomyopathy, Diastolic function, Heart failure, Prognosis, Strain, Strain rate, Systolic function, Tissue Doppler imaging, Ventricle dysfunction.