Heart failure diagnosis: the role of echocardiography and magnetic resonance imaging

Heart failure (HF) is the final common pathway of any heart disease, being a major cause of cardiovascular morbidity and mortality. Echocardiography is the most useful tool in the diagnosis of HF: echocardiographic evidence of left ventricular (LV) systolic dysfunction is generally associated with a dilated left ventricle (LV) and a reduced LV ejection fraction (EF). In many patients (pts) with symptoms of HF, however, EF and LV volumes are normal. Quantitative assessment of global and/or regional LV and right ventricle (RV) function is, therefore, necessary, and some emerging techniques, as Tissue Doppler Imaging (TDI) and Strain Imaging (SI), can provide such information. Moreover, cardiac magnetic resonance imaging (MRI) has emerged as an extremely useful technique in the investigation of pts with HF. Cardiac MRI permits calculation of myocardial mass, volumes and EF with Simpson's algorithm from three-dimensional data and with no geometric assumptions. The integration of conventional echocardiographic measurements, new echocardiographic parameters, and cardiac MRI is a very promising approach for an accurate evaluation of pts with HF.