Heart failure is an increasing problem in cardiology. The different diagnostic and prognostic information provided by echocardiography in such patients was discussed during this session.
Dr G W A De Keulaner from Antwerp, Belgium, showed data regarding the limitations of using ejection fraction (EF) as a cornerstone of classifying patients with heart failure. From the pathophysiological point of view the importance of EF has been over emphasised. Just differentiating heart failure patients into two groups (more and less than 50% EF) is not enough to provide diagnostic and prognostic information. Modern technology, such as Strain DTI should be used. EF alone is too insensitive for both systolic and diastolic dysfunction.
Following this lecture Dr A G Fraser of Cardiff, Wales, discussed the reasons why indices of radial function are misleading. The anatomical characteristics and transmural changes during contraction or differences in longitudinal and radial function of the left ventricle, are different aspects that should be considered when assessing left ventricular function.
Dr F Pinto from Lisbon, Portugal, also showed some potential limitations of echocardiography in assessing LV mass and volumes. He highlighted the importance of quantifying in an accurate way, left ventricular mass and volumes. Such measurements have important prognostic information and could be used to monitor therapeutic aspects.
In order to avoid technical limitations and those derived from geometrical assumptions, new technologies, such as 3D echocardiography, have been developed. Dr Pinto showed some interesting data about how 3D echocardiography provides data, similar to those obtained with MRI, in the assessment of left ventricular volumes.