Role of echocardiography in heart failure with preserved ejection fraction

This study aimed to investigate and analyze data regarding the role of echocardiographic examination in assessing the diastolic function of the left ventricle and diagnosing heart failure with preserved ejection fraction (HFpEF).

Materials and methods. A search of scientific publications and clinical recommendations was conducted in the PubMed and Google Scholar information-analytical systems for the years 2016–2022, using keywords such as diastolic dysfunction, diastolic stress test, heart failure with preserved ejection fraction, and echocardiography. Additionally, literature lists were analyzed to identify articles meeting the search criteria.

Results. A total of 140 articles were analyzed, with 27 of them utilized in composing the review. Eleven additional articles from 2003–2015 were included from literature lists. The search results were organized into article blocks, within which articles were analyzed to study the role of echocardiographic examination in assessing the diastolic function of the left ventricle and diagnosing HFpEF.

Conclusion: Echocardiographic examination provides crucial information about the structure and function of the heart and is recommended for all patients with suspected HFpEF. Based on routine assessment of tissue Doppler imaging parameters, ultrasound diagnostic physicians can decide on the need to initiate the diagnostic algorithm for HFpEF using the diastolic stress test method. Results of the diastolic stress test, considering its limitations, should be interpreted in accordance with the clinical scenario or the probability of the presence of HFpEF. A reduction in diastolic reserve (E/e > 15) is a cornerstone for confirming HFpEF. The key task of upcoming clinical trials is to better differentiate various clinical phenotypes of HFpEF, thereby improving the treatment of each specific patient with HFpEF.

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