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Updated: Aug 26, 2025
Lumped-Parameter and Finite Element Modeling of Heart Failure with Preserved Ejection Fraction
Published on: February 13, 2021
Approach to Echocardiography in Heart Failure with Preserved Ejection Fraction
C Charles Jain1, Yogesh N V Reddy2
1Cardiovascular Medicine, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA. Electronic address: https://twitter.com/charliejainmd.
Insights
Echocardiography is key for diagnosing heart failure with preserved ejection fraction (HFpEF) and understanding its causes. Emerging techniques like left atrial strain show promise for more accurate, noninvasive HFpEF diagnosis.
Area of Science:
- Cardiology
- Medical Imaging
Background:
- Echocardiography is a standard tool for evaluating suspected heart failure with preserved ejection fraction (HFpEF).
- It is crucial for excluding other causes of heart failure.
Purpose of the Study:
- To highlight the role of echocardiography in diagnosing and phenotyping HFpEF.
- To explore current and emerging echocardiographic methods for HFpEF assessment.
Main Methods:
- Review of echocardiographic applications in HFpEF diagnosis and phenotyping.
- Discussion of current limitations in assessing filling pressures.
- Introduction of novel techniques like left atrial strain.
Main Results:
- Echocardiography effectively excludes alternative heart failure etiologies.
- It provides insights into HFpEF pathophysiology, including atrial mechanics and pulmonary hypertension.
- Current Doppler assessments of filling pressures lack sensitivity for HFpEF diagnosis.
Conclusions:
- Echocardiography is indispensable for HFpEF evaluation.
- Emerging technologies like LA strain offer potential for improved noninvasive diagnosis.
Abstract:
As echocardiography is universally performed in the evaluation of suspected heart failure with preserved ejection fraction (HFpEF), a number of structural and functional characteristics relevant to both the diagnosis and phenotyping of HFpEF can be elucidated. Exclusion of alternate causes of heart failure is a critical first step performed principally by echocardiography. Once HFpEF is confirmed, echocardiography may provide insight into pathophysiology and phenotyping by quantifying atrial mechanics, pericardial restraint, degree of pulmonary hypertension, and atrial valvular regurgitation. Although current echo-Doppler assessment of filling pressures is insensitive to diagnose HFpEF, there are emerging technologies such as left atrial (LA) strain that hold promise for noninvasive diagnosis.
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