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Multimodality imaging in decompensated heart failure
Antonello D'Andrea1,2, Federica Ilardi3,4, Stefano Palermi3
1Unit of Cardiology, Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli", Monaldi Hospital, Via Leonardo Bianchi, 80131 Naples, Italy.
Insights
Diagnosing heart failure (HF) relies on clinical assessment and imaging. Advanced techniques like cardiac MRI and scintigraphy offer crucial insights for HF diagnosis and management.
Area of Science:
- Cardiology
- Medical Imaging
Background:
- Heart failure (HF) diagnosis typically involves clinical evaluation, ECG, and natriuretic peptides.
- Transthoracic echocardiography is the primary non-invasive imaging tool for assessing myocardial structure and function in HF.
- Echocardiography is vital for diagnosing HF with reduced, mildly reduced, and preserved ejection fraction, guiding therapy, and monitoring treatment response.
Purpose of the Study:
- To review the evolving role of imaging techniques in heart failure.
- To highlight the specific contributions of cardiac magnetic resonance and myocardial scintigraphy in HF diagnosis and management.
Main Methods:
- Review of current literature on cardiac imaging in heart failure.
- Focus on transthoracic echocardiography as a first-line tool.
- Emphasis on cardiac magnetic resonance and myocardial scintigraphy for advanced HF assessment.
Main Results:
- Echocardiography is fundamental for HF diagnosis and management.
- Cardiac MRI and myocardial scintigraphy provide complementary information for complex HF cases.
- Technological advancements enhance the understanding of HF pathophysiology through imaging.
Conclusions:
- Imaging techniques are indispensable for comprehensive heart failure diagnosis and management.
- Cardiac MRI and myocardial scintigraphy play incremental roles beyond echocardiography.
- Continued advancements in imaging are crucial for improving HF patient outcomes.
Abstract:
Heart failure (HF) is usually suspected by clinical history, symptoms, physical examination, electrocardiogram findings, and natriuretic peptides' values. However, echocardiography and other imaging techniques play an essential role in supporting HF diagnosis. Thanks to its non-invasiveness and safety, transthoracic echocardiography is the first-level technique of choice to assess myocardial structure and function, trying to establish the diagnosis of HF with reduced, mildly reduced, and preserved ejection fraction. The role of echocardiography is not limited to diagnosis but it represents a crucial tool in guiding therapeutic decision-making and monitoring response to therapy. Over the last decades, several technological advancements were made in the imaging field, aiming at better understanding the morphofunctional abnormalities occurring in cardiovascular diseases. The purpose of this review article is to summarize the incremental role of imaging techniques (in particular cardiac magnetic resonance and myocardial scintigraphy) in HF, highlighting their essential applications to HF diagnosis and management.
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