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Basic and advanced echocardiography in advanced heart failure: an overview

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Abstract

Advanced chronic heart failure (ACHF) is the last phase in the evolution of heart failure and is characterized by high hospitalization and mortality rates and is refractory to medical therapy, therefore requiring more aggressive therapies, such as mechanical circulatory support or heart transplantation. Over the last years, the incidence of ACHF was continuously growing, together with the increase in population survival rates. Therefore, the early recognition of the transition to ACHF is of crucial importance in HF patients, which also helps in prognostication of such patients, since advanced therapeutic options are limited to selected patients and they also have some important risk implications. Echocardiography is the gold standard tool for the evaluation of patients with HF; moreover, the recent technological advances provided new structural and functional indices of the four cardiac chambers that showed to be comparable to advanced imaging or invasive hemodynamic parameters. This allows us to operate an accurate study of ACHF with first- and second-level echocardiographic techniques, which are now being integrated in daily clinical practice. The present review presents an overview of the currently available tools for the echocardiographic examination of patients with ACHF, with its advantages and limitations, based on the latest supporting evidences.

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Authors and Affiliations

  1. Department of Cardiovascular Diseases, University of Siena, Viale Bracci 1, Siena, Italy

    Maria Concetta Pastore, Giulia Elena Mandoli, Serafina Valente, Sergio Mondillo & Matteo Cameli

  2. Adult Intensive Care Unit, Royal Brompton and Harefield NHS Foundation Trust, London, UK

    Hatem Soliman Aboumarie

  3. Department of Advanced Biomedical Science, Federico II University Hospital Naples, Naples, Italy

    Ciro Santoro, Roberta Esposito, Regina Sorrentino & Maurizio Galderisi

  4. Cardiology University Department, Heart Failure Unit, IRCCS, Policlinico San Donato, San Donato Milanese and Department of Biomedical Sciences for Health, University of Milano, Milan, Italy

    Francesco Bandera

  5. Division of Cardiology, Umberto I’ Hospital Nocera Inferiore (Salerno), Luigi Vanvitelli University, Caserta, Italy

    Antonello D’Andrea

  6. Division of Cardiology, Department of Medicine, University of Verona, Verona, Italy

    Giovanni Benfari

  7. Department of Health Promotion Sciences, Maternal-Infant Care, Internal Medicine and Specialities of Excellence “G. D’Alessandro,” University of Palermo, Cardiology Unit, University Hospital P. Giaccone, Palermo, Italy

    Vincenzo Evola

  8. Department of Clinical Medical and Neurosciences, Respiratory Disease and Lung Transplantation Section, Le Scotte Hospital, University of Siena, Siena, Italy

    Paolo Cameli

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Pastore, M.C., Mandoli, G.E., Aboumarie, H.S. et al. Basic and advanced echocardiography in advanced heart failure: an overview. Heart Fail Rev 25, 937–948 (2020). https://doi.org/10.1007/s10741-019-09865-3

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