The role of multimodality imaging in patients with heart failure with reduced and preserved ejection fraction

Abstract

Purpose of reviewThe burden of clinical heart failure, both heart failure with a reduced ejection fraction (HFrEF) and with a preserved ejection fraction (HFpEF), continues to increase both nationally and globally. This review summarizes the expanding role of multimodality imaging techniques in the evaluation and management these patients. Recent findingsEchocardiographic assessment for heart failure continues to expand and should include a robust hemodynamic and strain assessment. Nuclear techniques have also continued to evolve and advances including computed tomography attenuation correction for single photon emission-computed tomography positron-emission tomography increase diagnostic accuracy as well as provide information such as myocardial blood flow and viability assessment. Computed tomography imaging, already well established in the assessment of coronary and valvular disease, has increasing utility in the characterization of myopathy, and cardiac magnetic resonance imaging (MRI) continues to expand its role in tissue characterization to a wider breadth of diseases, including right ventricular cardiomyopathy and left ventricle noncompaction.

Artificial Intelligence and Its Role in Diagnosing Heart Failure: A Narrative Review

“…Cardiac MRI has excellent utility in tissue characterization, which is helpful in various diseases, such as ventricle noncompaction and right ventricular cardiomyopathy [65]. On the other hand, CT imaging is functional for assessing coronary and valvular diseases and is also helpful in characterizing myopathies [65].…”

“…On the other hand, there are certain limitations to these traditional imaging techniques. The quality and interpretation of images can vary due to factors such as limited acoustic windows and dependency on the operator [65]. In addition, there are several other constraints in the use of imaging in HF, like patientspecific contraindications, accessibility, high cost, availability of technical expertise, and need for specialized centers [65][66][67][68].…”

“…Other imaging techniques include X-rays, cardiac MRI, and computed tomography imaging (CT) [ 62 , 65 ]. Patients with HF commonly present with dyspnoea, in which case an X-ray is initially used to differentiate between pulmonary and cardiac causes [ 11 ].…”

Insuficiência Cardíaca Com Fração De Ejeção Preservada: Desafios Diagnósticos E Estratégias Terapêuticas Emergentes

“…Na realidade, a RMC fornece medidas relevantes da estrutura e função cardíaca, permite a caracterização dos tecidos e pode facilitar o diagnóstico precoce da ICFEp. O principal problema é sua disponibilidade na prática clínica diária 100,101 .…”

Positron Emission Tomography in Heart Failure: From Pathophysiology to Clinical Application

“…In the field of HF, different imaging techniques are used in daily practice to guide diagnosis, risk stratification, and treatment [74]. Whereas echocardiography remains the frontline modality for initial assessment, the role of computed tomography, CMR, and nuclear imaging continues to expand (Table 2) [75]. A detailed review of techniques for multimodality imaging in HF is beyond the scope of this paper.…”