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Quantifying left ventricular function in heart failure: What makes a clinically valuable parameter?
Markus Borge Harbo1, Einar Sjaastad Nordén2, Jagat Narula3
1Institute for Experimental Medical Research, Oslo University Hospital and University of Oslo, Oslo, Norway; K.G. Jebsen Center for Cardiac Research, University of Oslo, Oslo, Norway.
Progress in Cardiovascular Diseases
|June 6, 2020
Summary
Deformation parameters offer a more direct measure of myocardial function than ejection fraction for diagnosing and managing heart failure (HF). A framework evaluating coupling to myocardial function, evidence, and feasibility guides clinical parameter selection.
Area of Science:
- Cardiology
- Biomedical Engineering
- Medical Imaging
Background:
- Noninvasive quantification of left ventricular (LV) function is crucial in heart failure (HF) management.
- Ejection fraction (EF) has traditionally been central, but deformation parameters like strain are gaining prominence.
Purpose of the Study:
- To introduce a framework for evaluating the clinical value of LV function parameters in HF.
- To compare the utility of EF and deformation parameters based on specific criteria.
Main Methods:
- A conceptual framework evaluating parameters based on: 1) coupling to myocardial function, 2) evidence base, and 3) technical feasibility.
- Review of existing literature on EF and deformation parameters in HF.
Main Results:
- Deformation parameters offer closer insight into underlying myocardial processes compared to EF's volumetric assessment.
- Clinical value depends on strong coupling to function, robust evidence, and technical feasibility.
Conclusions:
- Deformation parameters show significant potential in HF management due to their closer link to myocardial function.
- The proposed framework aids in selecting clinically valuable parameters for LV dysfunction assessment.
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