New perspectives in the echocardiographic hemodynamics multiparametric assessment of patients with heart failure.

Autor: Lisi M; Department of Cardiovascular Disease-AUSL Romagna, Division of Cardiology, Ospedale S. Maria delle Croci, Viale Randi 5, 48121, Ravenna, Italy. matteo.lisi@hotmail.it., Luisi GA; Department of Cardiovascular Disease-AUSL Romagna, Division of Cardiology, Ospedale S. Maria delle Croci, Viale Randi 5, 48121, Ravenna, Italy., Pastore MC; Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy., Mandoli GE; Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy., Benfari G; Section of Cardiology, Department of Medicine, University of Verona, Verona, Italy., Ilardi F; Department of Advanced Biomedical Sciences, Division of Cardiology, Federico II University Hospital, Via S. Pansini 5, 80131, Naples, Italy.; Mediterranea Cardiocentro, 80122, Naples, Italy., Malagoli A; Division of Cardiology, Nephro-Cardiovascular Department, Baggiovara Hospital, Baggiovara, Italy., Sperlongano S; Division of Cardiology, Department of Translational Medical Sciences, University of Campania Luigi Vanvitelli, Naples, Italy., Henein MY; Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden., Cameli M; Department of Cardiovascular Disease-AUSL Romagna, Division of Cardiology, Ospedale S. Maria delle Croci, Viale Randi 5, 48121, Ravenna, Italy., D'Andrea A; Department of Cardiology, Umberto I Hospital, 84014, Nocera Inferiore, SA, Italy.
Jazyk: angličtina
Zdroj: Heart failure reviews [Heart Fail Rev] 2024 Jul; Vol. 29 (4), pp. 799-809. Date of Electronic Publication: 2024 Mar 20.
DOI: 10.1007/s10741-024-10398-7
Abstrakt: International Guidelines consider left ventricular ejection fraction (LVEF) as an important parameter to categorize patients with heart failure (HF) and to define recommended treatments in clinical practice. However, LVEF has some technical and clinical limitations, being derived from geometric assumptions and is unable to evaluate intrinsic myocardial function and LV filling pressure (LVFP). Moreover, it has been shown to fail to predict clinical outcome in patients with end-stage HF. The analysis of LV antegrade flow derived from pulsed-wave Doppler (stroke volume index, stroke distance, cardiac output, and cardiac index) and non-invasive evaluation of LVFP have demonstrated some advantages and prognostic implications in HF patients. Speckle tracking echocardiography (STE) is able to unmask intrinsic myocardial systolic dysfunction in HF patients, particularly in those with LV preserved EF, hence allowing analysis of LV, right ventricular and left atrial (LA) intrinsic myocardial function (global peak atrial LS, (PALS)). Global PALS has been proven a reliable index of LVFP which could fill the gaps "gray zone" in the previous Guidelines algorithm for the assessment of LV diastolic dysfunction and LVFP, being added to the latest European Association of Cardiovascular Imaging Consensus document for the use of multimodality imaging in evaluating HFpEF. The aim of this review is to highlight the importance of the hemodynamics multiparametric approach of assessing myocardial function (from LVFP to stroke volume) in patients with HF, thus overcoming the limitations of LVEF.
(© 2024. The Author(s).)
Databáze: MEDLINE
Externí odkaz: