In clinical practice and multicenter HF trials, the etiology of HF has often been categorized into either ischemic cardiomyopathy or nonischemic cardiomyopathy [1,14]. Thus, once a case of HFrEF has been identified, the basic distinction between an ischemic etiology and a nonischemic etiology with the support from imaging (see Variant 3) facilitates further diagnostic assessment and therapeutic planning, with guidance in further imaging provided by other reports on appropriate use of imaging [15]. Overview of Imaging Modalities Radiography Chest Information provided by chest radiography about: (1) noncardiovascular (eg, lung parenchymal disease) and cardiovascular (eg, cardiomegaly) anatomy of the chest [16]; (2) pulmonary vascular and edema patterns (eg, stages of pulmonary venous hypertension) [17]; and (3) vascular (eg, chronic coronary atherosclerosis) [18] and nonvascular (eg, calcified pericardial thickening) [19] calcification has potential applications to evaluation of the aforementioned HF variants. The appropriateness of the chest radiograph in the setting of suspicion of acute or potentially unstable chronic cardiopulmonary disease by history or physical examination has been previously established [20]. US Echocardiography Transthoracic Stress or Resting Echocardiography relies on ultrasonic waves to produce dynamic, usually tomographic versus volumetric images emphasizing a wide range of functional measures of cardiac chamber function and intravascular and intracavity flow in normal and various disease states, including HF, from which important hemodynamic measurements can be made in most patients noninvasively by transthoracic echocardiography (TTE) [21,22]. Despite its relatively weaker anatomic and histologic evaluation capabilities compared to some other cardiac imaging modalities, its risk-free nature, unless performed more invasively as transesophageal echocardiography (TEE), facilitates its use in the assessment of HF.
Suspected New Onset and Known Nonacute Heart Failure. In clinical practice and multicenter HF trials, the etiology of HF has often been categorized into either ischemic cardiomyopathy or nonischemic cardiomyopathy [1,14]. Thus, once a case of HFrEF has been identified, the basic distinction between an ischemic etiology and a nonischemic etiology with the support from imaging (see Variant 3) facilitates further diagnostic assessment and therapeutic planning, with guidance in further imaging provided by other reports on appropriate use of imaging [15]. Overview of Imaging Modalities Radiography Chest Information provided by chest radiography about: (1) noncardiovascular (eg, lung parenchymal disease) and cardiovascular (eg, cardiomegaly) anatomy of the chest [16]; (2) pulmonary vascular and edema patterns (eg, stages of pulmonary venous hypertension) [17]; and (3) vascular (eg, chronic coronary atherosclerosis) [18] and nonvascular (eg, calcified pericardial thickening) [19] calcification has potential applications to evaluation of the aforementioned HF variants. The appropriateness of the chest radiograph in the setting of suspicion of acute or potentially unstable chronic cardiopulmonary disease by history or physical examination has been previously established [20]. US Echocardiography Transthoracic Stress or Resting Echocardiography relies on ultrasonic waves to produce dynamic, usually tomographic versus volumetric images emphasizing a wide range of functional measures of cardiac chamber function and intravascular and intracavity flow in normal and various disease states, including HF, from which important hemodynamic measurements can be made in most patients noninvasively by transthoracic echocardiography (TTE) [21,22]. Despite its relatively weaker anatomic and histologic evaluation capabilities compared to some other cardiac imaging modalities, its risk-free nature, unless performed more invasively as transesophageal echocardiography (TEE), facilitates its use in the assessment of HF.