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Advances in Cardiovascular Imaging

The Future of Cardiovascular Imaging in the Diagnosis and Management of Heart Failure, Part 1

Tasks and Tools

Thomas H. Marwick, MD, PhD and Markus Schwaiger, MD, PhD

From the University of Queensland (T.H.M.), Brisbane, Australia, and Technische Universität of Munich (M.S.), Munich, Germany.

Correspondence to Professor T. Marwick, University of Queensland School of Medicine, Princess Alexandra Hospital, Brisbane, Qld 4102, Australia. E-mail t.marwick@uq.edu.au

Key Words: electrocardiography • heart failure • imaging

An extract of the first 250 words of the full text is provided, because this article has no abstract.

	Introduction

 
Radiographic, ultrasound, nuclear, and magnetic resonance methods have become indispensable in the management of heart failure (HF). Imaging is widely used in decision making in HF, not only in relation to left ventricular (LV) systolic and diastolic function but also in the selection of medical, device, and surgical therapy in HF and valvular heart disease. Future developments in the care of advanced heart disease, including stem cell therapy, device therapy to control remodeling, and percutaneous valve interventions, as well as the need to identify subclinical heart disease, are likely to expand this use. Moreover, the epidemic of diabesity (diabetes and obesity) will augment the existing epidemic of HF just when it appeared to have peaked.¹ Large numbers of patients will need information from imaging to guide clinical decision making (Table 1). The sources of this information will need to be expeditious, inexpensive, and preferably objective and quantitative.²

View this table:   Table 1. Established HF: What the Clinician Needs

 

	Functional Measurements: The Cornerstone of HF Management

 
Although some of the measurements in HF patients are structural (LV mass and geometry), the main components of an imaging assessment in HF will continue to be primarily functional (LV ejection fraction, size, filling pressures, filling characteristics, and right ventricular [RV] function). A number of new technologies will enhance the future accuracy and reliability of these measures.

LV Volumes and Ejection Fraction
Routine techniques (contrast ventriculography, 2D echocardiography) provide real-time imaging in standard imaging planes. The only traditional method that has escaped this limitation has been radionuclide ventriculography, in which the ejection fraction is calculated from scintigraphic counts, . . . [Full Text of this Article]

This article has been cited by other articles:

				T. H. Marwick and M. Schwaiger The Future of Cardiovascular Imaging in the Diagnosis and Management of Heart Failure, Part 2: Clinical Applications Circ Cardiovasc Imaging, September 1, 2008; 1(2): 162 - 170. [Full Text] [PDF]