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Updated: Jan 3, 2026
In Vivo Quantitative Assessment of Myocardial Structure, Function, Perfusion and Viability Using Cardiac Micro-computed Tomography
Published on: February 16, 2016
[Cardiovascular imaging in heart failure]
Pascal Nhan1, Stéphane Ederhy1, Laurie Soulat-Dufour1
1AP-HP, hôpital Saint-Antoine, Sorbonne université, service de cardiologie, 184, rue du Faubourg Saint-Antoine, 75571 Paris cedex 12, France.
Insights
Transthoracic echocardiography is the primary tool for diagnosing and managing heart failure, assessing cardiac function, and detecting valve disease. Myocardial strain imaging aids in evaluating systolic function and identifying heart conditions, with altered strain indicating a poor prognosis.
Area of Science:
- Cardiology
- Cardiac Imaging
- Echocardiography
Background:
- Transthoracic echocardiography is the frontline cardiac imaging modality for heart failure diagnosis, management, and screening across all ejection fraction phenotypes.
- It provides comprehensive assessment of cardiac anatomy, biventricular systolic and diastolic function, intracardiac hemodynamics, and valvular heart disease.
Purpose of the Study:
- To highlight the pivotal role of echocardiography and myocardial strain imaging in heart failure assessment.
- To outline the indications for advanced imaging techniques like cardiac magnetic resonance in specific clinical scenarios.
Main Methods:
- Utilizing transthoracic echocardiography for comprehensive cardiac evaluation, including assessment of ventricular function and hemodynamics.
- Employing myocardial deformation imaging (strain) for evaluating systolic function, diagnosing specific heart diseases, and screening for preclinical dysfunction.
- Leveraging cardiac magnetic resonance for detailed myocardial tissue characterization and structural assessment, particularly in cases with suboptimal acoustic windows or complex congenital heart disease.
Main Results:
- Echocardiography enables detailed assessment of heart failure phenotypes and valve disease.
- Myocardial strain imaging is crucial for assessing systolic function, diagnosing specific heart conditions, and prognostication in heart failure.
- Altered global longitudinal strain is a significant predictor of poor prognosis in heart failure patients.
- Cardiac magnetic resonance is valuable for differentiating ischemic from non-ischemic cardiomyopathy and characterizing myocardial tissue in complex cases.
Conclusions:
- Transthoracic echocardiography is indispensable for the comprehensive evaluation of heart failure.
- Myocardial strain imaging offers critical insights into ventricular function and prognosis, guiding management and risk stratification.
- Cardiac magnetic resonance serves as a complementary tool for complex cardiac diagnoses and tissue characterization.
Abstract:
Transthoracic echocardiography remains the first-line cardiac imaging for diagnosis, management and screening of heart failure, whatever its phenotype (heart failure with reduced, mid-range and preserved ejection fraction). It allows anatomic characterization, systolic and diastolic functions of left and right ventricles assessment, intracardiac hemodynamic evaluation and for the assessment of valve disease. Myocardial deformation imaging (strain) is indicated in patients with heart failure for the assessment of systolic ventricles function and the diagnosis of specific heart diseases. Strain is indicated for the screening of preclinical myocardial dysfunction in patients at risk or exposed to cardiotoxic treatment. Altered global longitudinal strain is associated with a poor prognosis in heart failure. Cardiac magnetic resonance is recommended for the assessment of myocardial structure and function in subjects with poor acoustic window and patients with complex congenital heart diseases, in order to distinguish between ischemic and non-ischemic myocardial damage in patients with dilated cardiopathy and to characterize myocardial tissue in case of suspected specific heart disease.
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