Congestive heart failure echocardiography: Difference between revisions

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(/* 2013 2013 ACCF/AHA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines(DO NOT EDIT) {{cite journal |vauthors=Yancy CW, Jessup M, Bozkurt B, Butler J, Casey DE, Drazner MH, Fonarow GC, Geraci SA, Horwich T, Januzzi JL, Johnson MR, Kasper EK, Levy WC, Masoudi FA, McBride PE, McMurray JJ, Mitchell JE, Peterson PN, Riegel B, Sam F, Stevenson LW, Tang WH, Tsai EJ, Wilkoff BL |title=...)
(/* 2022 AHA/ACC/HFSA Heart Failure Guideline (DO NOT EDIT) {{cite journal| author=Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM | display-authors=etal| title=2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. | journal=Circulation | year= 2022 | volume= 145 | issue= 18 | pages= e876-e894 | pmid=35363500 | doi=10.1161/C...)
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== 2022 AHA/ACC/HFSA Heart Failure Guideline (DO NOT EDIT) <ref name="pmid35363500">{{cite journal| author=Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM | display-authors=etal| title=2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. | journal=Circulation | year= 2022 | volume= 145 | issue= 18 | pages= e876-e894 | pmid=35363500 | doi=10.1161/CIR.0000000000001062 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=35363500  }} </ref> ==
== 2022 AHA/ACC/HFSA Heart Failure Guideline (DO NOT EDIT) <ref name="pmid35363500">{{cite journal| author=Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM | display-authors=etal| title=2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. | journal=Circulation | year= 2022 | volume= 145 | issue= 18 | pages= e876-e894 | pmid=35363500 | doi=10.1161/CIR.0000000000001062 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=35363500  }} </ref> ==


===Echocardiography in Patients Presenting With Heart Failure (DO NOT EDIT) <ref name="Hunt"> Hunt SA, Abraham WT, Chin MH, Feldman AM, Francis GS, Ganiats TG, Jessup M, Konstam MA, Mancini DM, Michl K, Oates JA, Rahko PS, Silver MA, Stevenson LW, Yancy CW, Antman EM, Smith SC Jr, Adams CD, Anderson JL, Faxon DP, Fuster V, Halperin JL, Hiratzka LF, Jacobs AK, Nishimura R, Ornato JP, Page RL, Riegel B; American College of Cardiology; American Heart Association Task Force on Practice Guidelines; American College of Chest Physicians; International Society for Heart and Lung Transplantation; Heart Rhythm Society. ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Update the 2001 Guidelines for the Evaluation and Management of Heart Failure): developed in collaboration with the American College of Chest Physicians and the International Society for Heart and Lung Transplantation: endorsed by the Heart Rhythm Society. Circulation. 2005 Sep 20; 112(12): e154-235. Epub 2005 Sep 13. PMID 16160202</ref><ref name="pmid19324967">Jessup M, Abraham WT, Casey DE, Feldman AM, Francis GS, Ganiats TG et al. (2009) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=19324967 2009 focused update: ACCF/AHA Guidelines for the Diagnosis and Management of Heart Failure in Adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: developed in collaboration with the International Society for Heart and Lung Transplantation.] ''Circulation'' 119 (14):1977-2016. [http://dx.doi.org/10.1161/CIRCULATIONAHA.109.192064 DOI:10.1161/CIRCULATIONAHA.109.192064] PMID: [http://pubmed.gov/19324967 19324967]</ref>===
===Evaluation With Cardiac Imaging 2022 AHA/ACC/HFSA Heart Failure Guideline (DO NOT EDIT) <ref name="pmid35363500">{{cite journal| author=Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM | display-authors=etal| title=2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. | journal=Circulation | year= 2022 | volume= 145 | issue= 18 | pages= e876-e894 | pmid=35363500 | doi=10.1161/CIR.0000000000001062 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=35363500  }} </ref> ===


{|class="wikitable" style="width:80%"
{|class="wikitable" style="width:80%"
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| colspan="1" style="text-align:center; background:LightGreen"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class I]]
|colspan="1" style="text-align:center; background:LightGreen"| [[ACC AHA guidelines classification scheme#Classification of Recommendations|Class I]]


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| bgcolor="LightGreen"|<nowiki>"</nowiki>'''1.''' Two-dimensional [[echocardiography]] with [[Doppler echocardiography|Doppler]] should be performed during initial evaluation of patients presenting with [[heart failure]] to assess [[left ventricular ejection fraction]], left ventricular size, wall thickness, and valve function. Radionuclide [[ventriculography]] can be performed to assess [[left ventricular ejection fraction]] and volumes. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' <nowiki>"</nowiki>
| bgcolor="LightGreen"|<nowiki>"</nowiki>'''2.''' In [[patients]] with suspected or newly diagnosed [[HF]], [[transthoracic echocardiography]] ([[TTE]]) should be performed during initial evaluation to assess [[cardiac]] structure and function. <ref name="pmid18848689">{{cite journal| author=Tribouilloy C, Rusinaru D, Mahjoub H, Goissen T, Lévy F, Peltier M| title=Impact of echocardiography in patients hospitalized for heart failure: a prospective observational study. | journal=Arch Cardiovasc Dis | year= 2008 | volume= 101 | issue= 7-8 | pages= 465-73 | pmid=18848689 | doi=10.1016/j.acvd.2008.06.012 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18848689  }} </ref> ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C-LD]])'' <nowiki>"</nowiki>
|-
| bgcolor="LightGreen"|<nowiki>"</nowiki>'''2.''' Repeat measurement of EF and measurement of the severity of structural remodeling are useful to provide information in patients with HF who have had a significant change in clinical status; who have experienced or recovered from a clinical event; or who have received treatment, including GDMT, that might have had a significant effect on cardiac function; or who may be candidates for device therapy.''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' <nowiki>"</nowiki>
|}
|}


{|class="wikitable" style="width:80%"
{|class="wikitable" style="width:80%"
|-
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| colspan="1" style="text-align:center; background:LightCoral"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class III]] (No Benefit)
|colspan="1" style="text-align:center; background:LemonChiffon"| [[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIb]]
|-
 
| bgcolor="LightCoral"|<nowiki>"</nowiki>Routine repeat measurement of LV function assessment in the absence of clinical status change or treatment interventions should not be performed.<ref name="pmid21349406">{{cite journal |vauthors=Douglas PS, Garcia MJ, Haines DE, Lai WW, Manning WJ, Patel AR, Picard MH, Polk DM, Ragosta M, Ward RP, Weiner RB |title=ACCF/ASE/AHA/ASNC/HFSA/HRS/SCAI/SCCM/SCCT/SCMR 2011 Appropriate Use Criteria for Echocardiography. A Report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, American Society of Echocardiography, American Heart Association, American Society of Nuclear Cardiology, Heart Failure Society of America, Heart Rhythm Society, Society for Cardiovascular Angiography and Interventions, Society of Critical Care Medicine, Society of Cardiovascular Computed Tomography, and Society for Cardiovascular Magnetic Resonance Endorsed by the American College of Chest Physicians |journal=J. Am. Coll. Cardiol. |volume=57 |issue=9 |pages=1126–66 |year=2011 |pmid=21349406 |doi=10.1016/j.jacc.2010.11.002 |url=}}</ref> ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])''<nowiki>"</nowiki>
|-
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| bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''7.''' In [[patients]] with [[HF]] and [[coronary artery disease]] ([[CAD]]) who are candidates for [[coronary revascularization]], noninvasive [[stress imaging]] ([[stress echocardiography]], [[single-photon emission CT]] [SPECT], CMR, or [[positron emission tomography]] [PET] may be considered for detection of [[myocardial ischemia]] to help guide [[coronary revascularization]]. <ref name="pmid11923039">{{cite journal| author=Allman KC, Shaw LJ, Hachamovitch R, Udelson JE| title=Myocardial viability testing and impact of revascularization on prognosis in patients with coronary artery disease and left ventricular dysfunction: a meta-analysis. | journal=J Am Coll Cardiol | year= 2002 | volume= 39 | issue= 7 | pages= 1151-8 | pmid=11923039 | doi=10.1016/s0735-1097(02)01726-6 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11923039  }} </ref><ref name="pmid19761983">{{cite journal| author=D'Egidio G, Nichol G, Williams KA, Guo A, Garrard L, deKemp R | display-authors=etal| title=Increasing benefit from revascularization is associated with increasing amounts of myocardial hibernation: a substudy of the PARR-2 trial. | journal=JACC Cardiovasc Imaging | year= 2009 | volume= 2 | issue= 9 | pages= 1060-8 | pmid=19761983 | doi=10.1016/j.jcmg.2009.02.017 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19761983  }} </ref><ref name="pmid23595888">{{cite journal| author=Ling LF, Marwick TH, Flores DR, Jaber WA, Brunken RC, Cerqueira MD | display-authors=etal| title=Identification of therapeutic benefit from revascularization in patients with left ventricular systolic dysfunction: inducible ischemia versus hibernating myocardium. | journal=Circ Cardiovasc Imaging | year= 2013 | volume= 6 | issue= 3 | pages= 363-72 | pmid=23595888 | doi=10.1161/CIRCIMAGING.112.000138 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23595888  }} </ref><ref name="pmid25617608">{{cite journal| author=Orlandini A, Castellana N, Pascual A, Botto F, Cecilia Bahit M, Chacon C | display-authors=etal| title=Myocardial viability for decision-making concerning revascularization in patients with left ventricular dysfunction and coronary artery disease: a meta-analysis of non-randomized and randomized studies. | journal=Int J Cardiol | year= 2015 | volume= 182 | issue=  | pages= 494-9 | pmid=25617608 | doi=10.1016/j.ijcard.2015.01.025 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25617608  }} </ref><ref name="pmid16198841">{{cite journal| author=Desideri A, Cortigiani L, Christen AI, Coscarelli S, Gregori D, Zanco P | display-authors=etal| title=The extent of perfusion-F18-fluorodeoxyglucose positron emission tomography mismatch determines mortality in medically treated patients with chronic ischemic left ventricular dysfunction. | journal=J Am Coll Cardiol | year= 2005 | volume= 46 | issue= 7 | pages= 1264-9 | pmid=16198841 | doi=10.1016/j.jacc.2005.06.057 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16198841  }} </ref> ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence:B-NR]])'' <nowiki>"</nowiki>


==Vote on and Suggest Revisions to the Current Guidelines==
==Vote on and Suggest Revisions to the Current Guidelines==

Revision as of 19:28, 22 June 2022
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ACC/AHA Guideline Recommendations

Initial and Serial Evaluation of the HF Patient
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Patients at high risk for developing heart failure (Stage A)
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Risk calculators and risk factors for Congestive heart failure echocardiography

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Lakshmi Gopalakrishnan, M.B.B.S. [2];Seyedmahdi Pahlavani, M.D. [3]

Overview

Echocardiography is commonly used to diagnose and monitor the progression of heart failure. This modality uses ultrasound to determine the stroke volume (SV, the amount of blood in the heart that exits the ventricles with each beat), the end-diastolic volume (EDV, the total amount of blood at the end of diastole), and the SV divided by the EDV, a value known as the ejection fraction (EF). In pediatrics, the shortening fraction is the preferred measure of systolic function.

Abnormalities Detected / Evaluated on Echocardiography in Congestive Heart Failure

The most useful diagnostic test in the evaluation of patients with or at risk for HF (eg, postacute MI) is a comprehensive 2-dimensional echocardiogram; coupled with Doppler flow studies, the transthoracic echocardiogram can identify abnormalities of myocardium, heart valves, and pericardium. Echocardiography can detect subclinical HF and predict[1] risk of subsequent events.

LVEF is reduced, LV structure is abnormal, and other structural abnormalities are present that could account for the clinical presentation. This information should be

Echocardiography can be used in the following ways:

Echocardiographic findings must be quantified, including numerical estimates of EF measurement, ventricular dimensions, wall thickness, calculations of ventricular volumes, and evaluation of chamber geometry and regional wall motion.

Documentation of LVEF is an HF quality-of-care performance measure.[2]

Right ventricular size and function as well as atrial size and dimensions should also be measured.

All valves should be evaluated for anatomic and flow abnormalities.

Many of these abnormalities are prognostically important and can be present without manifest HF.[3]

Serial echocardiographic evaluations are useful because evidence of cardiac reverse remodeling can provide important information in patients who have had a change in clinical status.

2022 AHA/ACC/HFSA Heart Failure Guideline (DO NOT EDIT) [4]

Evaluation With Cardiac Imaging 2022 AHA/ACC/HFSA Heart Failure Guideline (DO NOT EDIT) [4]

Class I
"2. In patients with suspected or newly diagnosed HF, transthoracic echocardiography (TTE) should be performed during initial evaluation to assess cardiac structure and function. [5] (Level of Evidence: C-LD) "
Class IIb
"7. In patients with HF and coronary artery disease (CAD) who are candidates for coronary revascularization, noninvasive stress imaging (stress echocardiography, single-photon emission CT [SPECT], CMR, or positron emission tomography [PET] may be considered for detection of myocardial ischemia to help guide coronary revascularization. [6][7][8][9][10] (Level of Evidence:B-NR) "

Vote on and Suggest Revisions to the Current Guidelines

Echocardiography videos

{{#ev:youtube|GJ_oRyryIbc}}

Sources


References

  1. ↑ Agha SA, Kalogeropoulos AP, Shih J, Georgiopoulou VV, Giamouzis G, Anarado P, Mangalat D, Hussain I, Book W, Laskar S, Smith AL, Martin R, Butler J (2009). "Echocardiography and risk prediction in advanced heart failure: incremental value over clinical markers". J. Card. Fail. 15 (7): 586–92. doi:10.1016/j.cardfail.2009.03.002. PMID 19700135.
  2. ↑ Bonow RO, Bennett S, Casey DE, Ganiats TG, Hlatky MA, Konstam MA, Lambrew CT, Normand SL, Pina IL, Radford MJ, Smith AL, Stevenson LW, Burke G, Eagle KA, Krumholz HM, Linderbaum J, Masoudi FA, Ritchie JL, Rumsfeld JS, Spertus JA (2005). "ACC/AHA Clinical Performance Measures for Adults with Chronic Heart Failure: a report of the American College of Cardiology/American Heart Association Task Force on Performance Measures (Writing Committee to Develop Heart Failure Clinical Performance Measures): endorsed by the Heart Failure Society of America". Circulation. 112 (12): 1853–87. doi:10.1161/CIRCULATIONAHA.105.170072. PMID 16160201.
  3. ↑ Yancy CW, Jessup M, Bozkurt B, Butler J, Casey DE, Drazner MH, Fonarow GC, Geraci SA, Horwich T, Januzzi JL, Johnson MR, Kasper EK, Levy WC, Masoudi FA, McBride PE, McMurray JJ, Mitchell JE, Peterson PN, Riegel B, Sam F, Stevenson LW, Tang WH, Tsai EJ, Wilkoff BL (2013). "2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines". J. Am. Coll. Cardiol. 62 (16): e147–239. doi:10.1016/j.jacc.2013.05.019. PMID 23747642.
  4. ↑ 4.0 4.1 Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM; et al. (2022). "2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines". Circulation. 145 (18): e876–e894. doi:10.1161/CIR.0000000000001062. PMID 35363500 Check |pmid= value (help).
  5. ↑ Tribouilloy C, Rusinaru D, Mahjoub H, Goissen T, Lévy F, Peltier M (2008). "Impact of echocardiography in patients hospitalized for heart failure: a prospective observational study". Arch Cardiovasc Dis. 101 (7–8): 465–73. doi:10.1016/j.acvd.2008.06.012. PMID 18848689.
  6. ↑ Allman KC, Shaw LJ, Hachamovitch R, Udelson JE (2002). "Myocardial viability testing and impact of revascularization on prognosis in patients with coronary artery disease and left ventricular dysfunction: a meta-analysis". J Am Coll Cardiol. 39 (7): 1151–8. doi:10.1016/s0735-1097(02)01726-6. PMID 11923039.
  7. ↑ D'Egidio G, Nichol G, Williams KA, Guo A, Garrard L, deKemp R; et al. (2009). "Increasing benefit from revascularization is associated with increasing amounts of myocardial hibernation: a substudy of the PARR-2 trial". JACC Cardiovasc Imaging. 2 (9): 1060–8. doi:10.1016/j.jcmg.2009.02.017. PMID 19761983.
  8. ↑ Ling LF, Marwick TH, Flores DR, Jaber WA, Brunken RC, Cerqueira MD; et al. (2013). "Identification of therapeutic benefit from revascularization in patients with left ventricular systolic dysfunction: inducible ischemia versus hibernating myocardium". Circ Cardiovasc Imaging. 6 (3): 363–72. doi:10.1161/CIRCIMAGING.112.000138. PMID 23595888.
  9. ↑ Orlandini A, Castellana N, Pascual A, Botto F, Cecilia Bahit M, Chacon C; et al. (2015). "Myocardial viability for decision-making concerning revascularization in patients with left ventricular dysfunction and coronary artery disease: a meta-analysis of non-randomized and randomized studies". Int J Cardiol. 182: 494–9. doi:10.1016/j.ijcard.2015.01.025. PMID 25617608.
  10. ↑ Desideri A, Cortigiani L, Christen AI, Coscarelli S, Gregori D, Zanco P; et al. (2005). "The extent of perfusion-F18-fluorodeoxyglucose positron emission tomography mismatch determines mortality in medically treated patients with chronic ischemic left ventricular dysfunction". J Am Coll Cardiol. 46 (7): 1264–9. doi:10.1016/j.jacc.2005.06.057. PMID 16198841.
  11. ↑ Hunt SA, Abraham WT, Chin MH, Feldman AM, Francis GS, Ganiats TG, Jessup M, Konstam MA, Mancini DM, Michl K, Oates JA, Rahko PS, Silver MA, Stevenson LW, Yancy CW, Antman EM, Smith SC Jr, Adams CD, Anderson JL, Faxon DP, Fuster V, Halperin JL, Hiratzka LF, Jacobs AK, Nishimura R, Ornato JP, Page RL, Riegel B; American College of Cardiology; American Heart Association Task Force on Practice Guidelines; American College of Chest Physicians; International Society for Heart and Lung Transplantation; Heart Rhythm Society. ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Update the 2001 Guidelines for the Evaluation and Management of Heart Failure): developed in collaboration with the American College of Chest Physicians and the International Society for Heart and Lung Transplantation: endorsed by the Heart Rhythm Society. Circulation. 2005 Sep 20; 112(12): e154-235. Epub 2005 Sep 13. PMID 16160202
  12. ↑ Jessup M, Abraham WT, Casey DE, Feldman AM, Francis GS, Ganiats TG et al. (2009) 2009 focused update: ACCF/AHA Guidelines for the Diagnosis and Management of Heart Failure in Adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: developed in collaboration with the International Society for Heart and Lung Transplantation. Circulation 119 (14):1977-2016. DOI:10.1161/CIRCULATIONAHA.109.192064 PMID: 19324967

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