Characterizing heart failure in the ventricular volume domain.

Area of Science:

• Cardiology
• Medical Imaging
• Physiology

Background:

• Heart failure (HF) presents diverse left ventricular (LV) volume alterations.
• HF variants share elevated LV filling pressures, impacting LV size and shape.
• One HF type shows near-normal LV end-diastolic volume (EDV) and reduced LV end-systolic volume (ESV).

Purpose of the Study:

• To investigate the utility of graphical representation of LV end-systolic volume (ESV) versus end-diastolic volume (EDV) for classifying HF subtypes.
• To determine if ESV and EDV relationships can differentiate major HF phenotypes.
• To propose a refined HF classification system based on LV volume dynamics.

Main Methods:

• Graphical analysis relating ESV to EDV to visualize HF subtypes.
• Comparison of LV volume patterns between different HF groups and healthy controls.
• Evaluation of the information content of ESV and EDV compared to ejection fraction (EF) for HF classification.

Main Results:

• Two major HF phenotypes occupy distinct regions in the ESV-EDV domain.
• ESV exhibits different dependency patterns on EDV across the two HF groups.
• Ejection fraction (EF) provides limited information within the LV volume representation compared to ESV and EDV.

Conclusions:

• A classification system for HF based on ESV and EDV graphical representation can distinguish distinct phenotypes.
• End-systolic volume (ESV) patterns are crucial for a superior heart failure classification system.
• Focusing on ESV dynamics offers a more informative approach to understanding and classifying heart failure.