title: Left ventricular strain and twisting in heart failure with preserved ejection fraction: an updated review.
abstract: Despite the high prevalence of the patients with heart failure with preserved ejection fraction (HFpEF), our knowledge about this entity, from diagnostic tools to therapeutic approach, is still not well established. The evaluation of patients with HFpEF is mainly based on echocardiography, as the most widely accepted tool in cardiac imaging. Identification of left ventricular (LV) diastolic dysfunction has long been considered as the only responsible for HFpEF, and its evaluation is still "sine qua non" of HFpEF diagnostics. However, one should be aware of the fact that identifying cardiac dysfunction in HFpEF might be very challenging and often needs more complex evaluation of cardiac structure and function. New echocardiographic modalities such as 2D and 3D speckle tracking imaging could help in the diagnosis of HFpEF and provide further information regarding LV function and mechanics. Early diagnosis, medical management, and adequate monitoring of HFpEF patients are prerequisites of modern medical treatment. New healthcare approaches require individualized patient care, which is why clinicians should have all clinical, laboratory, and diagnostic data before making final decisions about the treatment of any patients. This is particularly important for HFpEF that often remains undiagnosed for quite a long time, which further prolongs the beginning of adequate treatment and brings into question outcome of these patients. The aim of this article is to provide the overview of the main principles of LV mechanics and summarize recent data regarding LV strain in patients with HFpEF.
authors.affiliation: Department of Cardiology, Charité-University Medicine Berlin, Campus Virchow-Klinikum (CVK), Augustenburger Platz 1, 13353, Berlin, Germany. marijana_tadic@hotmail.com.
authors.forename: Marijana
authors.initials: M
authors.lastname: Tadic
authors.affiliation: Department of Cardiology, Charité-University Medicine Berlin, Campus Virchow-Klinikum (CVK), Augustenburger Platz 1, 13353, Berlin, Germany.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Pieske-Kraigher
authors.affiliation: University of Milano-Bicocca, Istituto Auxologico Italiano, Clinical Research Unit, Viale della Resistenza 23, 20036, Meda, Italy.
authors.forename: Cesare
authors.initials: C
authors.lastname: Cuspidi
authors.affiliation: Department of Cardiology, Charité-University Medicine Berlin, Campus Virchow-Klinikum (CVK), Augustenburger Platz 1, 13353, Berlin, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Genger
authors.affiliation: Department of Cardiology, Charité-University Medicine Berlin, Campus Virchow-Klinikum (CVK), Augustenburger Platz 1, 13353, Berlin, Germany.
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Morris
authors.affiliation: Department of Cardiology, Charité-University Medicine Berlin, Campus Virchow-Klinikum (CVK), Augustenburger Platz 1, 13353, Berlin, Germany.
authors.forename: Kun
authors.initials: K
authors.lastname: Zhang
authors.affiliation: Department of Cardiology, Charité-University Medicine Berlin, Campus Virchow-Klinikum (CVK), Augustenburger Platz 1, 13353, Berlin, Germany.
authors.forename: Nina Alexandra
authors.initials: NA
authors.lastname: Walther
authors.affiliation: Department of Cardiology, Charité-University Medicine Berlin, Campus Virchow-Klinikum (CVK), Augustenburger Platz 1, 13353, Berlin, Germany.|Deutsches Zentrum für Herz-Kreislauf-Forschung (DZHK), Standort Berlin/Charité, Berlin, Germany.|Department of Cardiology, Deutsches Herzzentrum Berlin (DHZB), Berlin, Germany.
authors.forename: Burket
authors.initials: B
authors.lastname: Pieske
mesh_terms: D019468:Disease Management; D004452:Echocardiography; D006333:Heart Failure / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D013318:Stroke Volume / Q000502:physiology*; D016277:Ventricular Function, Left / Q000502:physiology*
keywords: Heart failure with preserved ejection fraction; Left ventricle; Strain