Tomoko S Kato1,2, Masao Daimon3,4, Toru Satoh5. 1. Department of Medicine, Division of Cardiology, Showa University Koto Toyosu Hospital, 5-1-38 Toyosu, Koto-ku, Tokyo, 135-8577, Japan. rinnko@sannet.ne.jp. 2. Department of Cardiovascular Medicine, Juntendo University School of Medicine, Tokyo, Japan. rinnko@sannet.ne.jp. 3. Department of Cardiovascular Medicine, The University of Tokyo Hospital, Tokyo, Japan. 4. Department of Clinical Laboratory, The University of Tokyo Hospital, Tokyo, Japan. 5. Department of Cardiovascular Medicine, Kyorin University, Tokyo, Japan.
Abstract
PURPOSE OF REVIEW: Noninvasive hemodynamic assessments in patients with heart failure (HF) are essential for appropriate diagnosis and establishment of the best treatment strategies. Recently, the impact of pulmonary circulation and right ventricular function on prognosis in HF patients has drawn increasing attention. In this article, we explore the usefulness of cardiac imaging for hemodynamic assessments, mainly focusing on echocardiographic evaluation. RECENT FINDINGS: The reliability of Doppler echocardiography as a noninvasive alternative to Swan-Ganz catheterization has been well investigated with higher than 80% accuracy for estimating pulmonary artery pressure. Strain measurement and three-dimensional echocardiography are useful for evaluating right ventricular function together with pulmonary circulation. The accuracy of analyzing left and right ventricular functions by cardiac computed tomography and cardiac magnetic resonate imaging has also been established. These modalities can provide myocardial tissue information and allow calculation of the extracellular volume fraction as well. According to the rapid improvement of technologies, cardiac imaging has become an essential tool for hemodynamic evaluation in HF management.
PURPOSE OF REVIEW: Noninvasive hemodynamic assessments in patients with heart failure (HF) are essential for appropriate diagnosis and establishment of the best treatment strategies. Recently, the impact of pulmonary circulation and right ventricular function on prognosis in HF patients has drawn increasing attention. In this article, we explore the usefulness of cardiac imaging for hemodynamic assessments, mainly focusing on echocardiographic evaluation. RECENT FINDINGS: The reliability of Doppler echocardiography as a noninvasive alternative to Swan-Ganz catheterization has been well investigated with higher than 80% accuracy for estimating pulmonary artery pressure. Strain measurement and three-dimensional echocardiography are useful for evaluating right ventricular function together with pulmonary circulation. The accuracy of analyzing left and right ventricular functions by cardiac computed tomography and cardiac magnetic resonate imaging has also been established. These modalities can provide myocardial tissue information and allow calculation of the extracellular volume fraction as well. According to the rapid improvement of technologies, cardiac imaging has become an essential tool for hemodynamic evaluation in HF management.
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