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Left Heart Failure
Leila Rezai Gharai, MD; John D. Grizzard, MD; Lowie M. R. Van Assche, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        TERMINOLOGY

        • Synonyms

          • Left ventricular (LV) failure
          • Congestive heart failure (CHF)
            • CHF often used interchangeably with LV failure: LV failure should be differentiated from biventricular and right ventricular (RV) failure
        • Definitions

          • Pathophysiologic state: Abnormality of myocardial function responsible for failure of heart to pump blood at rate commensurate with requirements of metabolizing tissues during ordinary activity
          • HF with reduced EF (HFrEF; previously known as systolic HF): Decrease in myocardial contractility
          • HF with preserved EF (HFpEF; previously known as diastolic HF): LVEDV and stroke volume are preserved; there is, however, abnormal decrease in LV diastolic distensibility

        IMAGING

        • General Features

          • Radiographic Findings

            • CT Findings

              • MR Findings

                • Echocardiographic Findings

                  • Nuclear Medicine Findings

                    • Imaging Recommendations

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • General Features

                          • Staging, Grading, & Classification

                            • Gross Pathologic & Surgical Features

                              • Microscopic Features

                                CLINICAL ISSUES

                                • Presentation

                                  • Demographics

                                    • Natural History & Prognosis

                                      • Treatment

                                        DIAGNOSTIC CHECKLIST

                                        • Consider

                                          • Image Interpretation Pearls

                                            Selected References

                                            1. Brown PF et al: Towards cardiac MRI based risk stratification in idiopathic dilated cardiomyopathy. Heart. ePub, 2018
                                            2. Messroghli DR et al: Correction to: Clinical recommendations for cardiovascular magnetic resonance mapping of T1, T2, T2* and extracellular volume: A consensus statement by the Society for Cardiovascular Magnetic Resonance (SCMR) endorsed by the European Association for Cardiovascular Imaging (EACVI). J Cardiovasc Magn Reson. 20(1):9, 2018
                                            3. Cerny V et al: Utility of cardiac CT for evaluating delayed contrast enhancement in dilated cardiomyopathy. Herz. 42(8):776-780, 2017
                                            4. Messroghli DR et al: Clinical recommendations for cardiovascular magnetic resonance mapping of T1, T2, T2* and extracellular volume: a consensus statement by the Society for Cardiovascular Magnetic Resonance (SCMR) endorsed by the European Association for Cardiovascular Imaging (EACVI). J Cardiovasc Magn Reson. 19(1):75, 2017
                                            5. Panjrath G et al: Diagnosis and management of heart failure in older adults. Heart Fail Clin. 13(3):427-444, 2017
                                            6. Lee HJ et al: Myocardial Extracellular Volume Fraction with Dual-Energy Equilibrium Contrast-enhanced Cardiac CT in Nonischemic Cardiomyopathy: A Prospective Comparison with Cardiac MR Imaging. Radiology. 280(1):49-57, 2016
                                            7. Goldman-Cecil Medicine. 24th ed. Philadelphia: W. B. Saunders. 298-305, 2016
                                            8. Braunwald's heart disease : a textbook of cardiovascular medicine. Philadelphia, PA : Elsevier/Saunders, 2018, 2019.
                                            Related Anatomy
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                                            Related Differential Diagnoses
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                                            References
                                            Tables

                                            Tables

                                            KEY FACTS

                                            • Terminology

                                              • Imaging

                                                • Top Differential Diagnoses

                                                  TERMINOLOGY

                                                  • Synonyms

                                                    • Left ventricular (LV) failure
                                                    • Congestive heart failure (CHF)
                                                      • CHF often used interchangeably with LV failure: LV failure should be differentiated from biventricular and right ventricular (RV) failure
                                                  • Definitions

                                                    • Pathophysiologic state: Abnormality of myocardial function responsible for failure of heart to pump blood at rate commensurate with requirements of metabolizing tissues during ordinary activity
                                                    • HF with reduced EF (HFrEF; previously known as systolic HF): Decrease in myocardial contractility
                                                    • HF with preserved EF (HFpEF; previously known as diastolic HF): LVEDV and stroke volume are preserved; there is, however, abnormal decrease in LV diastolic distensibility

                                                  IMAGING

                                                  • General Features

                                                    • Radiographic Findings

                                                      • CT Findings

                                                        • MR Findings

                                                          • Echocardiographic Findings

                                                            • Nuclear Medicine Findings

                                                              • Imaging Recommendations

                                                                DIFFERENTIAL DIAGNOSIS

                                                                  PATHOLOGY

                                                                  • General Features

                                                                    • Staging, Grading, & Classification

                                                                      • Gross Pathologic & Surgical Features

                                                                        • Microscopic Features

                                                                          CLINICAL ISSUES

                                                                          • Presentation

                                                                            • Demographics

                                                                              • Natural History & Prognosis

                                                                                • Treatment

                                                                                  DIAGNOSTIC CHECKLIST

                                                                                  • Consider

                                                                                    • Image Interpretation Pearls

                                                                                      Selected References

                                                                                      1. Brown PF et al: Towards cardiac MRI based risk stratification in idiopathic dilated cardiomyopathy. Heart. ePub, 2018
                                                                                      2. Messroghli DR et al: Correction to: Clinical recommendations for cardiovascular magnetic resonance mapping of T1, T2, T2* and extracellular volume: A consensus statement by the Society for Cardiovascular Magnetic Resonance (SCMR) endorsed by the European Association for Cardiovascular Imaging (EACVI). J Cardiovasc Magn Reson. 20(1):9, 2018
                                                                                      3. Cerny V et al: Utility of cardiac CT for evaluating delayed contrast enhancement in dilated cardiomyopathy. Herz. 42(8):776-780, 2017
                                                                                      4. Messroghli DR et al: Clinical recommendations for cardiovascular magnetic resonance mapping of T1, T2, T2* and extracellular volume: a consensus statement by the Society for Cardiovascular Magnetic Resonance (SCMR) endorsed by the European Association for Cardiovascular Imaging (EACVI). J Cardiovasc Magn Reson. 19(1):75, 2017
                                                                                      5. Panjrath G et al: Diagnosis and management of heart failure in older adults. Heart Fail Clin. 13(3):427-444, 2017
                                                                                      6. Lee HJ et al: Myocardial Extracellular Volume Fraction with Dual-Energy Equilibrium Contrast-enhanced Cardiac CT in Nonischemic Cardiomyopathy: A Prospective Comparison with Cardiac MR Imaging. Radiology. 280(1):49-57, 2016
                                                                                      7. Goldman-Cecil Medicine. 24th ed. Philadelphia: W. B. Saunders. 298-305, 2016
                                                                                      8. Braunwald's heart disease : a textbook of cardiovascular medicine. Philadelphia, PA : Elsevier/Saunders, 2018, 2019.