Echocardiography predicts adverse cardiac remodelling in heart failure.

SUMMARY Echocardiography can be used to assess the determinants ofprognosis in patients with heart failure. It is an easily availabletool to assess LVEF, size and shape, LA and PAP and size andfunction of right atrium and RV. The availability of continuous-wave Doppler has permitted the evaluation pulmonary arterysystolic pressure from TR which provides additional informa-tion. In long-standing heart failure, pulmonary artery wedgepressure is a predictor of survival, and aggressive therapy toreduce wedge pressure improves survival. Noninvasive estima-tion of LA pressure and LV filling pressure has been attemptedby continuous-wave Doppler echocardiography in patientswith heart failure and MR and by tissue Doppler imaging at themitral annulus level. Two-dimensional echocardiographicevaluation of ventricular size and function and pulsed- andcontinuous-wave Doppler recordings from the pulmonaryartery, pulmonary vein and mitral inflow are combined to pro-vide these data. These are both qualitative and quantitative,and permit the estimation of ventricular ejection fraction, LApressure and cardiac output. It would be important to risk-stratify patients with CHF based on their noninvasive testingresults so that appropriate therapies could be targeted to highrisk patients.