New and old echographic parameters in heart failure

Echography (ECHO) is a first-line technology for diagnostic evaluation and prognostic stratification of patients with heart failure (HF). Recognizing specific diseases or conditions amenable to specific treatment is a crucial step in the work-up of patients with HF. Left ventricular ejection fraction (EF) measurement, despite its pathophysiological and methodological limitations, is the primary parameter for the HF classification, incorporating forms with reduced, moderately reduced, and preserved ejection fraction. The cardiac filling parameters could characterize the haemodynamic profile of the various forms of HF and guide different clinical therapeutic strategies. Besides the conventional parameters, widely validated by the clinical practice (old parameters), ECHO provides new information on cardiac function (deformation index), which prospectively could refine our phenotypic classification, beyond EF, thus opening new prospects in the pre-clinical identification, and in the selection of the appropriate treatment for HF patients Stemming from the recent technologic improvements, it is possible to analyse conventional parameters with innovative and automatic approaches, which are quickly available, and able to open new perspectives in the treatment of patients with HF.