Multimodality Imaging in Advanced Heart Failure. A Clinical Consensus Statement of the Heart Failure Association of the ESC. Part 1: Multimodality Imaging for the Evaluation of Patients with Advanced Heart Failure

Heart failure (HF) represents a significant global health burden, with approximately 10% of patients progressing to advanced stages characterized by severe symptoms and recurrent hospitalizations despite conventional treatments such as guideline-directed medical therapy, devices, and surgery. This clinical consensus statement from the Heart Failure Association of the European Society of Cardiology discusses the applications of imaging modalities in patients with advanced HF. Transthoracic echocardiography remains the cornerstone for initial diagnosis and monitoring, providing critical insights into cardiac volumes, function, and valvular integrity, as well as congestion status. Transoesophageal echocardiography offers detailed evaluations of valve pathology, essential for surgical or transcatheter planning. Cardiovascular magnetic resonance provides comprehensive assessments of biventricular size and function, tissue characterization, and flow dynamics, proving particularly useful for diagnosing specific HF aetiologies. Computed tomography offers valuable insights into pulmonary artery diameter, right ventricular volume, and valvular anatomy, which are crucial for guiding percutaneous procedures. Nuclear imaging techniques allow assessing viability and diagnosing non-ischaemic HF conditions, guiding revascularization decisions. Advanced imaging techniques have expanded the understanding and management of right ventricular dysfunction. The integration of these advanced imaging modalities enhances diagnostic accuracy, risk stratification, and therapeutic decision-making, ultimately improving the prognosis and quality of life for patients with advanced HF. This clinical consensus statement highlights the critical role of various imaging modalities in managing patients with advanced HF, excluding those needing mechanical circulatory support or heart transplantation, emphasizing the multifaceted approach required for effective management.

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Publication Details

Journal
European Journal of Heart Failure
Published
2025-10-14
DOI
https://doi.org/10.1002/ejhf.3762
Primary Topic
Cardiac Valve Diseases and Treatments
Type
article
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article

Multimodality Imaging in Advanced Heart Failure. A Clinical Consensus Statement of the Heart Failure Association of the ESC. Part 1: Multimodality Imaging for the Evaluation of Patients with Advanced Heart Failure

Marco Masetti, Finn Gustafsson, Julien Dreyfus, Shahrukh Hashmani et al.
European Journal of Heart Failure
Cardiac Valve Diseases and Treatments
article

Multimodality Imaging in Advanced Heart Failure. A Clinical Consensus Statement of the Heart Failure Association of the ESC. Part 1: Multimodality Imaging for the Evaluation of Patients with Advanced Heart Failure

Marco Masetti, Finn Gustafsson, Julien Dreyfus, Shahrukh Hashmani, Stamatis Adamopoulos, Ahmet Çelik, Linda W. van Laake, Michael Bonios, Ify Mordi, Kevin Damman, Marco Metra, Ralph Stephan von Bardeleben, Ovidiu Chioncel, Maja Čikeš, Laurens F. Tops, Concetta Di Nora, Alberto Aimo, Tuvia Ben Gal, Brenda Moura, Sanem Nalbantgil, Maria G. Crespo‐Leiro
article en

Abstract

Heart failure (HF) represents a significant global health burden, with approximately 10% of patients progressing to advanced stages characterized by severe symptoms and recurrent hospitalizations despite conventional treatments such as guideline-directed medical therapy, devices, and surgery. This clinical consensus statement from the Heart Failure Association of the European Society of Cardiology discusses the applications of imaging modalities in patients with advanced HF. Transthoracic echocardiography remains the cornerstone for initial diagnosis and monitoring, providing critical insights into cardiac volumes, function, and valvular integrity, as well as congestion status. Transoesophageal echocardiography offers detailed evaluations of valve pathology, essential for surgical or transcatheter planning. Cardiovascular magnetic resonance provides comprehensive assessments of biventricular size and function, tissue characterization, and flow dynamics, proving particularly useful for diagnosing specific HF aetiologies. Computed tomography offers valuable insights into pulmonary artery diameter, right ventricular volume, and valvular anatomy, which are crucial for guiding percutaneous procedures. Nuclear imaging techniques allow assessing viability and diagnosing non-ischaemic HF conditions, guiding revascularization decisions. Advanced imaging techniques have expanded the understanding and management of right ventricular dysfunction. The integration of these advanced imaging modalities enhances diagnostic accuracy, risk stratification, and therapeutic decision-making, ultimately improving the prognosis and quality of life for patients with advanced HF. This clinical consensus statement highlights the critical role of various imaging modalities in managing patients with advanced HF, excluding those needing mechanical circulatory support or heart transplantation, emphasizing the multifaceted approach required for effective management.

European Journal of Heart FailureVol. 27(11)
Valve (United States) (US), University Medical Center Groningen (NL), University Hospital Centre Zagreb (HR), Vita-Salute San Raffaele University (IT), Carol Davila University of Medicine and Pharmacy (RO), Scuola Superiore Sant'Anna (IT), Tel Aviv University (IL), University of Groningen (NL), University of Dundee (GB), University of Zagreb (HR), Utrecht University (NL), Leiden University Medical Center (NL), Rabin Medical Center (IL), Copenhagen University Hospital (DK), Rigshospitalet (DK), University Medical Center Utrecht (NL), Ege University (TR), Institutul de Urgenţă pentru Boli Cardiovasculare "Prof.Dr. C.C. Iliescu" (RO), Royal Brompton Hospital (GB), CUF Porto Hospital (PT), Armed Forces Hospital (SA), Onassis Cardiac Surgery Center (GR), Azienda USL di Bologna (IT), Ospedale Santa Maria della Misericordia di Udine (IT), Complexo Hospitalario Universitario A Coruña (ES), Centre Cardiologique du Nord (FR), Fondazione Toscana Gabriele Monasterio (IT), Azienda Sanitaria Universitaria Integrata di Trieste (IT), Mersin Üniversitesi (TR)
Openalex Percentile: Top 56%
Cardiac Valve Diseases and Treatments
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