Echocardiography in patients with heart failure: recent advances and future perspectives

Echocardiography is a relatively inexpensive and widely available technique that has a pivotal role in the assessment and management of patients with heart failure (HF). Advancements in cardiac ultrasound, especially the advent of myocardial deformation imaging, have provided a comprehensive insight into the complexity of cardiac derangements underlying HF, contributing to the better understanding of the disease process. The essential issues that echocardiography can help address include: establishing / confirming diagnosis, categorizing and phenotyping patients, prognosticating, guiding therapeutic decision-making, and monitoring responses to treatment. Novel echocardiographic technologies permit early recognition of preclinical myocardial abnormalities, as well as further tracking of pathologic alterations and therapeutic responses. The predictive utility of a large number of echocardiographic indices, offering an abundance of prognostic information independent of and incremental to clinical data, underpins their use in risk stratification strategies. The evolution of existing modalities, as well as the wider implementation of automation and artificial intelligence, provides the basis for the future development and expanded clinical application of echocardiography.