Are Non-Invasive Modalities for the Assessment of Atherosclerosis Useful for Heart Failure Predictions?

Abstract

Heart failure (HF) is becoming an increasingly common issue worldwide and is associated with significant morbidity and mortality, making its prevention an important clinical goal. The criteria evaluated using non-invasive modalities such as coronary artery calcification, the ankle-brachial index, and carotid intima-media thickness have been proven to be effective in determining the relative risk of atherosclerotic cardiovascular disease. Notably, risk assessments using these modalities have been proven to be superior to the traditional risk predictors of cardiovascular disease. However, the ability to assess HF risk has not yet been well-established. In this review, we describe the clinical significance of such non-invasive modalities of atherosclerosis assessments and examine their ability to assess HF risk. The predictive value could be influenced by the left ventricular ejection fraction. Specifically, when the ejection fraction is reduced, its predictive value increases because this condition is potentially a result of coronary artery disease. In contrast, using these measures to predict HF with a preserved ejection fraction may be difficult because it is a heterogeneous condition. To overcome this issue, further research, especially on HF with a preserved ejection fraction, is required.

Keywords: ankle-brachial index; cardio-ankle vascular index; carotid intima-media thickness; coronary artery calcification; heart failure.

Figure 1

Non-invasive modality of atherosclerosis assessment.

Figure 2

Clinical significance of non-invasive modalities used for assessment of atherosclerosis when evaluating the potential risk of heart failure.