and Marco Rengo1
(1)
Department of Radiological Sciences, Oncology and Pathology, Sapienza University of Rome-Polo Pontino, Latina, Italy
(2)
Department of Radiology and Radiological Sciences, Medical University of South Carolina, Charleston, SC, USA
Heart Failure
Clinical syndrome characterized by dyspnea and/or fatigue on exertion or at rest with evidence of fluid retention in the context of a structural or functional cardiac disorder.
Clinical diagnosis can be made with Framingham criteria.
Table 1
NYHA criteria
NYHA functional class | |
|---|---|
Class I | No limitation during ordinary activity |
Class II | Slight limitation by shortness of breath and/or fatigue during moderate exertion or stress |
Class III | Symptoms with minimal exertion that interfere with normal daily activity |
Class IV | Inability to carry out any physical activity |
Table 2
Framingham criteria for the diagnosis of heart failure
Framingham criteria | |
|---|---|
Major criteria | |
1. Paroxysmal nocturnal dyspnea | 5. S3 gallop rhythm |
2. Raised JVP; distended neck veins | 6. Hepatojugular reflux |
3. Crepitations in lung fields | 7. Weight loss >4.5 kg in 5 days in response to treatment |
4. Acute pulmonary edema | |
Minor criteria | |
1. Bilateral ankle edema | 5. Pleural effusion |
2. Nocturnal cough | 6. Tachycardia rate >120/min |
3. Dyspnea on ordinary exertion | 7. Decrease in vital capacity by one-third |
4. Hepatomegaly | |
Heart Failure, Diastolic
Symptoms and signs of heart failure with preserved systolic function.
Impaired ability of the left ventricle to fill in diastole.
Causes: ischemia, restrictive or infiltrative cardiomyopathy, hypertrophy.
Imaging technique to evaluate diastolic function: echocardiography with tissue Doppler or calculating E/A ratio.
E/A ratio: pulsed Doppler at mitral inflow measures E wave (peak early diastolic velocity) and A wave (peak atrial systolic velocity).
MR could indirectly assess diastolic dysfunction analyzing E/A ratio with through-plane phase contrast of mitral valve.
Table 3
Diastolic dysfunction classification
