Imaging in heart failure with preserved ejection fraction

Area of Science:

• Cardiology
• Medical Imaging
• Cardiovascular Physiology

Background:

• Heart failure with preserved ejection fraction (HFpEF) is increasingly prevalent.
• Accurate diagnosis and management of HFpEF require understanding its complex cardiac dysfunction.
• Identifying HFpEF can be challenging due to variable presentation.

Purpose of the Study:

• To review the role of imaging in assessing cardiac structure and function in HFpEF.
• To highlight the importance of integrated assessment for HFpEF diagnosis and management.
• To discuss the utility of stress testing in unmasking cardiac dysfunction in HFpEF.

Main Methods:

• Comprehensive transthoracic echocardiography is the primary noninvasive imaging modality.
• Assessment integrates cardiac structure, systolic and diastolic function, and hemodynamic parameters.
• Stress testing (exercise or pharmacologic) may be employed to reveal latent cardiac dysfunction.

Main Results:

• HFpEF diagnosis necessitates a multifaceted approach beyond resting assessment.
• Echocardiography provides crucial insights into the structural and functional abnormalities in HFpEF.
• Cardiac dysfunction in HFpEF may only manifest under increased cardiac demand.

Conclusions:

• Integrated echocardiographic assessment is vital for diagnosing and managing HFpEF.
• Understanding cardiac mechanics and hemodynamics is essential for HFpEF.
• Stress echocardiography can be instrumental in identifying HFpEF when resting studies are inconclusive.