Clinical Cardiology and Heart Failure Unit, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (ISMETT), Via Tricomi 5, 90127, Palermo, Italy.
Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA.
Heart Fail Rev. 2024 Nov;29(6):1247-1260. doi: 10.1007/s10741-024-10434-6. Epub 2024 Sep 19.
Echocardiography represents an essential tool for imagers and clinical cardiologists in the management of patients with heart failure. Advanced heart failure (AdHF) is a more severe and, typically, later stage of HF that exposes patients to a high risk of adverse outcomes, with a 1-year mortality rate of around 50%. Currently, several therapies are available to improve the outcomes of these patients, reduce their mortality rate, and, possibly, delay the need for advanced therapies such as heart transplant and long-term mechanical circulatory support. When accurately performed and interpreted, echocardiography provides crucial information to properly tailor medical and device therapy of patients with AdHF and to identify those at even higher risk. In this review, we present the state of the art of echocardiography applications in the clinical management of patients with AdHF. We will discuss the role of echocardiography chronologically, beginning with the prediction of AdHF, proceeding through diagnosis, and detailing how echocardiography informs clinical decision-making, before concluding with indications for advanced therapies.
超声心动图是影像科医生和临床心内科医生在心力衰竭患者管理中的重要工具。晚期心力衰竭（Advanced heart failure，AdHF）是心力衰竭的一个更严重且通常更晚期的阶段，使患者面临高不良事件风险，其 1 年死亡率约为 50%。目前，有多种疗法可用于改善这些患者的预后，降低死亡率，并可能延迟需要进行心脏移植和长期机械循环支持等先进疗法的时间。当准确进行和解释时，超声心动图可提供重要信息，以便为 AdHF 患者量身定制药物和器械治疗，并识别出风险更高的患者。在本次综述中，我们展示了超声心动图在 AdHF 患者临床管理中的应用现状。我们将按时间顺序讨论超声心动图的作用，从 AdHF 的预测开始，然后是诊断，并详细说明超声心动图如何为临床决策提供信息，最后介绍先进疗法的适应证。
