Conventional echocardiography |
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M-mode echocardiography |
Measures LV wall thickness |
Widely available |
Depends on imaging quality |
Finds stage C and D HF by LVEF |
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Calculates LV mass |
Quick and easy to obtain |
Requires precise imaging plane to apply M-mode perpendicularly |
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Calculates LVEF |
Depends on geographic assumptions |
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Measures LA dimension |
Inaccurate in distorted cardiac structure |
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2D-echocardiography |
Measures LV wall thickness |
More accurate than M-mode |
Depends on imaging quality |
Finds stage C and D HF |
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Calculates LV mass |
Widely available |
Operator dependent |
Classifies HF: HFrEF, HFmrEF, and HF-pEF |
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Measures LV volumes |
Less geometric assumptions than M-mode |
Requires precise imaging planes |
Detects associated cardiac lesions: VHD, thrombus, pericardial effusion, etc. |
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Measures LA dimension and volumes |
Inaccurate in distorted cardiac structure |
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Demonstrate abnormal cardiac structures |
Partial adjustment for shape distortions |
Identifies diastolic HF by LA volume |
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Doppler echocardiography |
Measures mitral inflow velocities |
Measures velocities of blood flow |
Angle dependent |
Identifies diastolic HF by E/e’ and TR Vmax |
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Estimates LV filling pressure by mitral inflow velocities |
Calculates pressure gradient between cardiac chambers |
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Measures TR Vmax |
Assesses pulmonary arterial pressure by TR Vmax |
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Estimates pulmonary arterial pressure |
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3D-echocardiography |
Measures LV volumes |
More accurate than 2D and M-mode echocardiography |
Depends on imaging quality |
Finds stage C and D HF |
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Calculates LVEF |
Lower temporal and spatial resolution |
Classifies HF: HFrEF, HFmrEF, and HF-pEF |
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Measures LA volumes |
Independent on geographic assumptions |
More time-consuming |
Detects associated cardiac lesions: VHD, thrombus, pericardial effusion, etc. |
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Demonstrates abnormal cardiac structures |
Less interobserver variability |
Needs experienced examiners |
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Gives better understanding about cardiac structures |
Requires regular stable heart rhythm and breath hold |
Identifies diastolic HF by LA volume |
Strain echocardiography |
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Tissue Doppler imaging (TDI) |
Measures mitral annular velocities |
High temporal resolution |
Angle dependent |
Identifies diastolic HF by E/e’ velocity and mitral annular velocities |
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Estimates LV filling pressure with mitral inflow and mitral annular velocities |
Less influenced by imaging quality |
Needs application of tissue |
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Doppler prior to strain measurement for off-line analysis |
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Measures regional myocardial strain |
Limited spatial resolution |
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High interobserver variability |
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Speckle tracking echocardiography |
Measures regional and global myocardial strain |
Less angle dependent than TDI |
Depends on imaging quality |
Identifies stage A and B HF |
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Better spatial resolution |
Only measures in two dimensions |
Estimates prognosis of HF by LVGLS |
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Better reproducibility than TDI |
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Stress echocardiography |
Evaluates regional wall motion abnormalities during exercise or pharmacologic stress |
Helps to determine the causes of cardiac symptoms in patients with normal echocardiographic results at rest |
Needs experienced examiners |
Detects HFpEF by demonstrating increased pulmonary arterial pressure during stress test |
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Depends on imaging quality |
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Measures TR Vmax and estimates pulmonary arterial pressure during exercise or pharmacologic stress |
Limited in patients with contraindications of dobutamine |
Detects combined CAD |
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Noninvasive assessment of CAD |
Limited in patients who cannot perform bicycle or treadmill exercise |
Determines functional capacity |