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Heart Failure Reviews
Published in: Heart Failure Reviews 1/2020

Open Access 01-01-2020 | Echocardiography

Structural and myocardial dysfunction in heart failure beyond ejection fraction

Authors: Paolo Severino, Viviana Maestrini, Marco Valerio Mariani, Lucia Ilaria Birtolo, Rossana Scarpati, Massimo Mancone, Francesco Fedele

Published in: Heart Failure Reviews | Issue 1/2020

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Abstract

Heart failure is a multifaceted syndrome addressing for a high rate of death among the general population. The common approach to this disease has been always based on the evaluation of the left ventricular ejection fraction by two-dimensional echocardiography with Simpson’s method. Mounting evidences have demonstrated the pitfalls of this method and have suggested that the management of heart failure requires a deep knowledge of the pathophysiological insights of the disease and cannot rely only on the evaluation of the left ventricular ejection fraction. Several advanced imaging technologies overwhelm the evaluation of ejection fraction and could provide a better understanding of the myocardial abnormalities underlying heart failure. Considering the limitation of left ventricular ejection fraction and the systemic involvement of heart failure, classifications of heart failure based on ejection fraction should be substituted with a comprehensive “staging” of multiorgan damage, not only considering the heart but also the lungs, kidneys, and liver, such as the HLM staging system. Such a holistic approach based on the HLM staging system and multimodality imaging can provide a global assessment of patient features allowing for targeted therapies and better heart failure management.
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Metadata
Title
Structural and myocardial dysfunction in heart failure beyond ejection fraction
Authors
Paolo Severino
Viviana Maestrini
Marco Valerio Mariani
Lucia Ilaria Birtolo
Rossana Scarpati
Massimo Mancone
Francesco Fedele
Publication date
01-01-2020
Publisher
Springer US
Published in
Heart Failure Reviews / Issue 1/2020
Print ISSN: 1382-4147
Electronic ISSN: 1573-7322
DOI
https://doi.org/10.1007/s10741-019-09828-8

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