Cardiac Systolic Mechanics in Heart Failure with Preserved Ejection Fraction: New Insights and Controversies.
Heart failure with preserved ejection fraction (HFpEF) is a cardinal and complex syndrome tightly linked to several co-morbidities, and is currently emerging as a new public health problem in the elderly population. However, despite aggressive intervention, patients with HFpEF typically have a poor prognosis. Part of the reason underlying this phenomenon can be attributed to the insufficiently understood pathophysiology behind this syndrome. Traditional echocardiography-derived parameters such as left ventricular (LV) ejection fraction (LVEF) may not be useful in characterizing such a clinical disorder, or in further identifying the subjects at risk, owing in part to its lack of power to disclose subclinical systolic dysfunction in such a clinical scenario. Herein, we briefly reviewed the clinical manifestations and risk factors of HFpEF, and further provided insights into the understanding of the ventricular architecture and cardiac mechanics underlying HFpEF by utilizing advanced cardiovascular imaging modalities, with a special focus on myocardial deformation.


BACKGROUND
Heart failure; Speckle tracking imaging; Strain.
Division of Cardiology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei; ; Mackay Medicine, Nursing and Management College;
Chi-In
CI
Lo
Division of Cardiology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei; ; Mackay Medicine, Nursing and Management College;
Yau-Hui
YH
Lai
Division of Cardiology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei; ; Department of Medicine, Mackay Medical College, New Taipei City;
Jih-Jer
JJ
Wu
Mackay Medicine, Nursing and Management College; ; Department of Medicine, Mackay Medical College, New Taipei City; ; Department of Radiology, Mackay Memorial Hospital;
Chun-Ho
CH
Yun
Division of Cardiology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei; ; Mackay Medicine, Nursing and Management College; ; Department of Medicine, Mackay Medical College, New Taipei City; ; Institute of Clinical Medicine, and Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan;
Chung-Lieh
CL
Hung
Brigham and Women's Hospital; ; Massachusetts College of Pharmacy and Health Sciences, Boston, MA, USA.
Bernard E
BE
Bulwer
Division of Cardiology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei; ; Department of Medicine, Mackay Medical College, New Taipei City;
Hung-I
HI
Yeh