Related Experiment Video
Updated: Jul 20, 2025
Echocardiographic Assessment Using Subxiphoid-Only Examination for Hypotensive Patients
Published on: April 18, 2025
Phenotyping heart failure by echocardiography: imaging of ventricular function and haemodynamics at rest and exercise
Otto A Smiseth1, Erwan Donal2, Espen Boe3
1Division of Cardiovascular and Pulmonary Diseases, Institute for Surgical Research, Oslo University Hospital and University of Oslo, Oslo, Norway.
Insights
Echocardiography using speckle tracking strain offers a more sensitive method for diagnosing heart failure (HF) systolic dysfunction than ejection fraction alone. Advanced echocardiographic parameters accurately identify elevated left ventricular filling pressures in HF with preserved ejection fraction (HFpEF).
Area of Science:
- Cardiology
- Medical Imaging
- Echocardiography
Background:
- Traditional heart failure (HF) phenotyping relies on left ventricular (LV) ejection fraction (LVEF) via echocardiography.
- Speckle tracking strain echocardiography offers enhanced sensitivity for detecting mild systolic dysfunction and identifying specific cardiomyopathies.
- HF with preserved ejection fraction (HFpEF) is characterized by elevated LV filling pressures, often requiring stress testing for diagnosis.
Purpose of the Study:
- To highlight the complementary role of LV strain analysis alongside LVEF in echocardiographic assessment of cardiac function.
- To emphasize the utility of echocardiographic parameters in diagnosing elevated LV filling pressures in HFpEF.
- To introduce novel echocardiographic parameters like LV work index and shear wave imaging for evaluating LV contractility and stiffness.
Main Methods:
- Utilizing speckle tracking strain echocardiography to assess LV global longitudinal strain and segmental patterns.
- Applying a set of echocardiographic parameters to diagnose elevated LV filling pressure in HFpEF.
- Investigating novel parameters such as LV work index and shear wave imaging.
Main Results:
- LV global longitudinal strain can reveal reduced contractility when LVEF is normal or supernormal, especially in hypertrophic ventricles.
- Echocardiographic parameters accurately identify elevated LV filling pressures, aiding in HFpEF diagnosis.
- Novel modalities like LV work index show promise for quantifying LV contractile function and efficiency.
Conclusions:
- Echocardiographic assessment of cardiac function should incorporate LV strain as a supplementary method to LVEF.
- Echocardiography provides accurate diagnostic tools for elevated LV filling pressure, crucial for identifying HFpEF.
- Further research is needed to determine the clinical utility of emerging techniques like shear wave imaging.
Abstract:
Traditionally, congestive heart failure (HF) was phenotyped by echocardiography or other imaging techniques according to left ventricular (LV) ejection fraction (LVEF). The more recent echocardiographic modality speckle tracking strain is complementary to LVEF, as it is more sensitive to diagnose mild systolic dysfunction. Furthermore, when LV systolic dysfunction is associated with a small, hypertrophic ventricle, EF is often normal or supernormal, whereas LV global longitudinal strain can reveal reduced contractility. In addition, segmental strain patterns may be used to identify specific cardiomyopathies, which in some cases can be treated with patient-specific medicine. In HF with preserved EF (HFpEF), a diagnostic hallmark is elevated LV filling pressure, which can be diagnosed with good accuracy by applying a set of echocardiographic parameters. Patients with HFpEF often have normal filling pressure at rest, and a non-invasive or invasive diastolic stress test may be used to identify abnormal elevation of filling pressure during exercise. The novel parameter LV work index, which incorporates afterload, is a promising tool for quantification of LV contractile function and efficiency. Another novel modality is shear wave imaging for diagnosing stiff ventricles, but clinical utility remains to be determined. In conclusion, echocardiographic imaging of cardiac function should include LV strain as a supplementary method to LVEF. Echocardiographic parameters can identify elevated LV filling pressure with good accuracy and may be applied in the diagnostic workup of patients suspected of HFpEF.
More Related Videos
07:49Author Spotlight: Investigating HR-Dependent Cardiac Function in Mouse Models Through a Novel Atrial-Pacing Approach
Published on: July 21, 2023
10:33Assessment of Right Ventricular Structure and Function in Mouse Model of Pulmonary Artery Constriction by Transthoracic Echocardiography
Published on: February 3, 2014
Related Concept Videos
01:17Imaging Studies for Cardiovascular System I:Echocardiography
Indications: Echocardiography is utilized to diagnose heart failure, valve disorders, and myocardial infarction. It also assesses cardiac structures' size, shape, and motion,...
01:20Imaging Studies for Cardiovascular System II:Types of Echocardiography
Types of Echocardiography
Transthoracic Echocardiography (TTE)
TTE is the most common type of echocardiogram which involves placing a transducer on the patient's chest, emitting sound waves to create heart images. TTE is invaluable for evaluating the heart's size, structure, and motion, making it particularly useful for...
01:17Pathophysiology of Heart Failure
01:29Heart Failure II: Pathophysiology
01:30Heart Failure IV: Classification and Diagnostic Evaluation
01:29Cardiomyopathy III: Hypertrophic Cardiomyopathy