IMR Press / RCM / Volume 22 / Issue 1 / DOI: 10.31083/j.rcm.2021.01.134
Open Access Review
Imaging in heart failure with preserved ejection fraction: insights into echocardiography and cardiac magnetic resonance imaging
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1 Department of Internal Medicine, University of Arizona College of Medicine, Tucson, AZ 85724, USA
2 Division of Cardiology, Sarver Heart Center, University of Arizona College of Medicine, Tucson, AZ 85724, USA

Academic Editor: Peter A. McCullough

Rev. Cardiovasc. Med. 2021, 22(1), 11–24;
Submitted: 13 July 2020 | Revised: 28 December 2020 | Accepted: 29 December 2020 | Published: 30 March 2021

Heart failure with preserved ejection fraction (HFpEF) is increasingly prevalent and represents more than half of all heart failure cases. It is defined by the presence of heart failure signs and symptoms, identification of cardiac structural abnormalities leading to high left ventricular filling pressures, and an EF > 50%. Common imaging findings in HFpEF include left ventricular hypertrophy, diastolic dysfunction, left atrial enlargement, and elevated pulmonary artery pressure (> 35 mm Hg). Echocardiography is the primary imaging modality for diagnosing HFpEF. It can be complemented by cardiac magnetic resonance (CMR) when further characterization is needed. Advances like real-time 3-dimensional echocardiography and speckle-tracking derived strain, as well as tissue characterization by CMR, have furthered our understanding of the mechanisms and aided in making the diagnosis of a diverse group of conditions that can present as HFpEF. This review aims to touch upon the imaging methods of characterizing HFpEF and discuss their role in specific disease entities.

Heart failure
Ejection fraction
Left ventricular hypertrophy
Cardiac magnetic resonance
Fig. 1.
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