Multimodality cardiac imaging in advanced heart failure: Diagnosis, risk stratification, and therapeutic guidance
- 1Department of Radiology, The First Affiliated Hospital of Wannan Medical University (Yijishan Hospital of Wannan Medical University), China
- 2Department of Cardiovascular Surgery, The First Affiliated Hospital of Wannan Medical University (Yijishan Hospital of Wannan Medical University), China
Abstract
Advanced heart failure represents a high-risk clinical stage in which imaging is used not only to document ventricular dysfunction but also to clarify etiology, assess right-sided reserve, define valvular and pulmonary vascular contributions, stratify risk, and determine suitability for advanced therapies. In this narrative review, guided by the Scale for the Assessment of Narrative Review Articles, we summarized the contemporary role of echocardiography, cardiac magnetic resonance, cardiac computed tomography, and selected nuclear imaging techniques in the evaluation of patients with advanced heart failure. A focused literature search of PubMed and major cardiology society guidance was performed to identify clinically relevant publications on multimodality imaging in advanced heart failure, durable mechanical circulatory support, transplantation, valvular intervention, and risk stratification. Echocardiography remains the first-line modality for bedside assessment of ventricular performance, congestion, filling pressures, and valve disease. Cardiac magnetic resonance is particularly useful for tissue characterization, fibrosis assessment, etiologic clarification, and arrhythmic risk evaluation. Cardiac computed tomography provides high-value anatomical information for procedural planning, including left ventricular assist device implantation and structural interventions. Nuclear imaging plays a more selective role in viability assessment and evaluation of infiltrative or inflammatory cardiomyopathies. A practical multimodality strategy should be question-driven rather than test-driven, with each modality selected according to the next management decision. This approach may improve clinical usefulness, reduce redundant testing, and better support individualized management in advanced heart failure.
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BibTeX
@article{xia2026multimodality,
title = {{Multimodality cardiac imaging in advanced heart failure: Diagnosis, risk stratification, and therapeutic guidance}},
author = {Shouli Xia and Youshi Wu and Hussain Asif and Saifane Zakaria and Weiyong Sheng},
journal = {The Journal of International Medical Research},
year = {2026},
month = sep,
doi = {10.1177/03000605261489329},
url = {https://doi.org/10.1177/03000605261489329},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Multimodality cardiac imaging in advanced heart failure: Diagnosis, risk stratification, and therapeutic guidance
AU - Shouli Xia
AU - Youshi Wu
AU - Hussain Asif
AU - Saifane Zakaria
AU - Weiyong Sheng
PY - 2026
DA - 2026/09/21
JO - The Journal of International Medical Research
DO - 10.1177/03000605261489329
UR - https://doi.org/10.1177/03000605261489329
AB - Advanced heart failure represents a high-risk clinical stage in which imaging is used not only to document ventricular dysfunction but also to clarify etiology, assess right-sided reserve, define valvular and pulmonary vascular contributions, stratify risk, and determine suitability for advanced therapies. In this narrative review, guided by the Scale for the Assessment of Narrative Review Articles, we summarized the contemporary role of echocardiography, cardiac magnetic resonance, cardiac computed tomography, and selected nuclear imaging techniques in the evaluation of patients with advanced heart failure. A focused literature search of PubMed and major cardiology society guidance was performed to identify clinically relevant publications on multimodality imaging in advanced heart failure, durable mechanical circulatory support, transplantation, valvular intervention, and risk stratification. Echocardiography remains the first-line modality for bedside assessment of ventricular performance, congestion, filling pressures, and valve disease. Cardiac magnetic resonance is particularly useful for tissue characterization, fibrosis assessment, etiologic clarification, and arrhythmic risk evaluation. Cardiac computed tomography provides high-value anatomical information for procedural planning, including left ventricular assist device implantation and structural interventions. Nuclear imaging plays a more selective role in viability assessment and evaluation of infiltrative or inflammatory cardiomyopathies. A practical multimodality strategy should be question-driven rather than test-driven, with each modality selected according to the next management decision. This approach may improve clinical usefulness, reduce redundant testing, and better support individualized management in advanced heart failure.
SN - 0300-0605
SN - 1473-2300
ER -