Echo and heart failure: when do people need an echo, and when do they need natriuretic peptides?
Heart failure (HF) is a threat to public health. Heterogeneities in aetiology and phenotype complicate the diagnosis and management of HF. This is especially true when considering HF with preserved ejection fraction (HFpEF), which makes up 50% of HF cases. Natriuretic peptides may aid in establishin...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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BMC
2018-05-01
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| Series: | Echo Research and Practice |
| Subjects: | |
| Online Access: | http://www.echorespract.com/content/5/2/R65.full |
| _version_ | 1811302616374706176 |
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| author | Daniel Modin Ditte Madsen Andersen Tor Biering-Sørensen |
| author_facet | Daniel Modin Ditte Madsen Andersen Tor Biering-Sørensen |
| author_sort | Daniel Modin |
| collection | DOAJ |
| description | Heart failure (HF) is a threat to public health. Heterogeneities in aetiology and phenotype complicate the diagnosis and management of HF. This is especially true when considering HF with preserved ejection fraction (HFpEF), which makes up 50% of HF cases. Natriuretic peptides may aid in establishing a working diagnosis in patients suspected of HF, but echocardiography remains the optimal choice for diagnosing HF. Echocardiography provides important prognostic information in both HF with reduced ejection fraction (HFrEF) and HFpEF. Traditionally, emphasis has been put on the left ventricular ejection fraction (LVEF). LVEF is useful for both diagnosis and prognosis in HFrEF. However, echocardiography offers more than this single parameter of systolic function, and for optimal risk assessment in HFrEF, an echocardiogram evaluating systolic, diastolic, left atrial and right ventricular function is beneficial. In this assessment echocardiographic modalities such as global longitudinal strain (GLS) by 2D speckle-tracking may be useful. LVEF offers little value in HFpEF and is neither helpful for diagnosis nor prognosis. Diastolic function quantified by E/e′ and systolic function determined by GLS offer prognostic insight in HFpEF. In HFpEF, other parameters of cardiac performance such as left atrial and right ventricular function evaluated by echocardiography also contribute with prognostic information. Hence, it is important to consider the entire echocardiogram and not focus solely on systolic function. Future research should focus on combining echocardiographic parameters into risk prediction models to adopt a more personalized approach to prognosis instead of identifying yet another echocardiographic biomarker. |
| first_indexed | 2024-04-13T07:31:19Z |
| format | Article |
| id | doaj.art-6e8a1b448c3b4aa1942b28764b52e95a |
| institution | Directory Open Access Journal |
| issn | 2055-0464 2055-0464 |
| language | English |
| last_indexed | 2024-04-13T07:31:19Z |
| publishDate | 2018-05-01 |
| publisher | BMC |
| record_format | Article |
| series | Echo Research and Practice |
| spelling | doaj.art-6e8a1b448c3b4aa1942b28764b52e95a2022-12-22T02:56:20ZengBMCEcho Research and Practice2055-04642055-04642018-05-0152R65R79https://doi.org/10.1530/ERP-18-0004Echo and heart failure: when do people need an echo, and when do they need natriuretic peptides?Daniel Modin0Ditte Madsen Andersen1Tor Biering-Sørensen2Department of Cardiology, Herlev & Gentofte Hospital, University of Copenhagen, Copenhagen, DenmarkDepartment of Cardiology, Herlev & Gentofte Hospital, University of Copenhagen, Copenhagen, DenmarkDepartment of Cardiology, Herlev & Gentofte Hospital, University of Copenhagen, Copenhagen, DenmarkHeart failure (HF) is a threat to public health. Heterogeneities in aetiology and phenotype complicate the diagnosis and management of HF. This is especially true when considering HF with preserved ejection fraction (HFpEF), which makes up 50% of HF cases. Natriuretic peptides may aid in establishing a working diagnosis in patients suspected of HF, but echocardiography remains the optimal choice for diagnosing HF. Echocardiography provides important prognostic information in both HF with reduced ejection fraction (HFrEF) and HFpEF. Traditionally, emphasis has been put on the left ventricular ejection fraction (LVEF). LVEF is useful for both diagnosis and prognosis in HFrEF. However, echocardiography offers more than this single parameter of systolic function, and for optimal risk assessment in HFrEF, an echocardiogram evaluating systolic, diastolic, left atrial and right ventricular function is beneficial. In this assessment echocardiographic modalities such as global longitudinal strain (GLS) by 2D speckle-tracking may be useful. LVEF offers little value in HFpEF and is neither helpful for diagnosis nor prognosis. Diastolic function quantified by E/e′ and systolic function determined by GLS offer prognostic insight in HFpEF. In HFpEF, other parameters of cardiac performance such as left atrial and right ventricular function evaluated by echocardiography also contribute with prognostic information. Hence, it is important to consider the entire echocardiogram and not focus solely on systolic function. Future research should focus on combining echocardiographic parameters into risk prediction models to adopt a more personalized approach to prognosis instead of identifying yet another echocardiographic biomarker.http://www.echorespract.com/content/5/2/R65.full2D echocardiography2D speckle-tracking echocardiographyheart failuremechanics |
| spellingShingle | Daniel Modin Ditte Madsen Andersen Tor Biering-Sørensen Echo and heart failure: when do people need an echo, and when do they need natriuretic peptides? Echo Research and Practice 2D echocardiography 2D speckle-tracking echocardiography heart failure mechanics |
| title | Echo and heart failure: when do people need an echo, and when do they need natriuretic peptides? |
| title_full | Echo and heart failure: when do people need an echo, and when do they need natriuretic peptides? |
| title_fullStr | Echo and heart failure: when do people need an echo, and when do they need natriuretic peptides? |
| title_full_unstemmed | Echo and heart failure: when do people need an echo, and when do they need natriuretic peptides? |
| title_short | Echo and heart failure: when do people need an echo, and when do they need natriuretic peptides? |
| title_sort | echo and heart failure when do people need an echo and when do they need natriuretic peptides |
| topic | 2D echocardiography 2D speckle-tracking echocardiography heart failure mechanics |
| url | http://www.echorespract.com/content/5/2/R65.full |
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