Assessing hemodynamics noninvasively in patients with heart failure.

PURPOSE OF REVIEW: Describe the contemporary assessment of cardiac hemodynamics using a comprehensive echo-Doppler examination in the heart failure (HF) patient.

RECENT FINDINGS: Cardiac flow and filling pressures, on both the left and right sides of the heart, are fundamental to the accurate assessment of the HF patient. Accurate assessment of left ventricular (LV) and right ventricular (RV) systolic and diastolic function is necessary to establish, or exclude, HF as a cause or component of dyspnea in a given patient and to help determine causes of hemodynamic instability in HF patients. Variables such as spectral Doppler (mitral and tricuspid inflow, pulmonary and hepatic venous flow, and pulmonary valve regurgitation signal), tissue Doppler imaging, and speckle tracking, applied to the left and right heart, can help to accurately estimate cardiac hemodynamics.

SUMMARY: A comprehensive echocardiogram with Doppler can provide an accurate assessment of left and right heart hemodynamics that is fundamental to the assessment and management of the HF patient.