Innovative imaging methods in heart failure: a shifting paradigm in cardiac assessment. Position statement on behalf of the Heart Failure Association of the European Society of Cardiology

Jelena Čelutkienė*, Carla M. Plymen, Frank A. Flachskampf, Rudolf A. de Boer, Julia Grapsa, Robert Manka, Lisa Anderson, Madalina Garbi, Vassilis Barberis, Pasquale Perrone Filardi, Paola Gargiulo, Jose Luis Zamorano, Mitja Lainscak, Petar Seferovic, Frank Ruschitzka, Giuseppe M.C. Rosano, Petros Nihoyannopoulos

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

87 Citations (Scopus)
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Abstract

Myriad advances in all fields of cardiac imaging have stimulated and reflected new understanding of cardiac performance, myocardial damage and the mechanisms of heart failure. In this paper, the Heart Failure Association assesses the potential usefulness of innovative imaging modalities in enabling more precise diagnostic and prognostic evaluation, as well as in guiding treatment strategies. Many new methods have gradually penetrated clinical practice and are on their way to becoming a part of routine evaluation. This paper focuses on myocardial deformation and three-dimensional ultrasound imaging; stress tests for the evaluation of contractile and filling function; the progress of magnetic resonance techniques; molecular imaging and other sound innovations. The Heart Failure Association aims to highlight the ways in which paradigms have shifted in several areas of cardiac assessment. These include reassessing of the simplified concept of ejection fraction and implementation of the new parameters of cardiac performance applicable to all heart failure phenotypes; switching from two-dimensional to more accurate and reproducible three-dimensional ultrasound volumetric evaluation; greater tissue characterization via recently developed magnetic resonance modalities; moving from assessing cardiac function and congestion at rest to assessing it during stress; from invasive to novel non-invasive hybrid techniques depicting coronary anatomy and myocardial perfusion; as well as from morphometry to the imaging of pathophysiologic processes such as inflammation and apoptosis. This position paper examines the specific benefits of imaging innovations for practitioners dealing with heart failure aetiology, risk stratification and monitoring, and, in addition, for scientists involved in the development of future research.

Original languageEnglish
Pages (from-to)1615-1633
Number of pages19
JournalEuropean Journal of Heart Failure
Volume20
Issue number12
DOIs
Publication statusPublished - Dec 2018
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2018 The Authors. European Journal of Heart Failure © 2018 European Society of Cardiology

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