Assessment of Left Ventricular Systolic and Diastolic Function by Echocardiography

Abstract

Echocardiography is the imaging method of choice in the evaluation of patients with heart failure (HF) due to its accuracy, availability, low cost and safety profile. It provides a wealth of information about left and right ventricular size, geometry and function, left atrium size, valve function, pulmonary pressures, and the pericardium. It provides evidence about the cause of HF, which is critical for the selection of the best treatment. The assessment of left ventricular (LV) ejection fraction (EF) is essential to differentiate HF with reduced ejection fraction from HF with preserved EF and HF with mid-range EF, and therefore to guide proper therapies based on LVEF cut-off values. Abnormalities in diastolic function are extremely common in patients with HF and either reduced or preserved LVEF and may have prognostic implications. Since LV diastolic dysfunction is thought to be the main pathophysiological abnormality in patients with HFpEF, evaluation of LV diastolic function and filling pressure is of utmost importance for both diagnostic and prognostic purposes. Thus, the information provided by a comprehensive echo exam aids greatly in the better management of HF patients.