Echocardiographic Assessment of Cardiac Function and Structure

Echocardiography utilises ultrasound to visualise cardiac chambers, valves and great vessels, providing real-time information on morphology, mechanics and haemodynamics. Transthoracic techniques combine two-dimensional imaging with Doppler modalities to measure chamber dimensions, wall thickness, ventricular volumes and valvular flow patterns. Speckle-tracking echocardiography quantifies myocardial deformation, enhancing detection of subtle systolic dysfunction, while tissue Doppler imaging assesses regional myocardial velocities to inform diastolic function and filling pressures. Three-dimensional imaging advances volumetric analysis and valve assessment without reliance on geometric assumptions. Standardised acquisition protocols and population-specific reference intervals ensure reproducibility and support early detection of cardiomyopathies, valvular disease and heart failure. Indexing parameters to body surface area facilitates personalised interpretation and risk stratification. Recent technological developments include automated border detection, artificial intelligence algorithms for image analysis, portable point-of-care devices and contrast agents to improve endocardial definition. Together, these advances underpin clinical decision-making across diverse healthcare settings by guiding diagnosis, monitoring therapy and informing prognostic evaluation.

Research from Nature Portfolio

Recent studies have demonstrated that indexing echocardiographic measures to body surface area optimises prognostic performance across body mass index categories. Analysis of more than two hundred thousand patients showed that left ventricular dimensions, mass and atrial volumes indexed to body surface area yielded superior prediction of cardiovascular mortality compared to unindexed values in underweight, normal weight, overweight and obese groups. Alternative indexing metrics, including lean body mass and height-based formulas, provided no clinically meaningful improvement over body surface area. These findings reinforce the universal application of body surface area indexation to improve risk stratification and standardise reporting in routine echocardiographic practice.

Echocardiographic Assessment of Cardiac Function and Structure publication trend

The graph below shows the total number of articles in echocardiographic assessment of cardiac function and structure across all publications each year (not limited to Nature Index journals).

Technical terms

Ejection fraction: The proportion of blood ejected from the left ventricle with each heartbeat, expressed as a percentage.

Speckle-tracking echocardiography: A method that follows natural acoustic markers in the myocardium to quantify myocardial strain and deformation.

Indexed measures: Echocardiographic dimensions or volumes adjusted for body surface area to allow comparison across individuals.

Tissue Doppler imaging: A Doppler technique that measures the velocity of myocardial tissue motion to assess regional systolic and diastolic function.

Left ventricular end-diastolic volume index: The left ventricular volume at end-diastole divided by body surface area, indicating chamber size relative to body size.

References

1. Prognostic association supports indexing size measures in echocardiography by body surface area. Scientific Reports (2023).
2. Normal Reference Intervals for Cardiac Dimensions and Function for Use in Echocardiographic Practice: A Guideline from the British Society of Echocardiography. Echo Research & Practice (2020).
3. A practical guideline for performing a comprehensive transthoracic echocardiogram in adults: the British Society of Echocardiography minimum dataset. Echo Research & Practice (2020).
4. Revisiting Echocardiographic Ranges of Left Ventricular End‐Diastolic Volume Index: An Analysis of the Discrepancies Between the 2006 and the 2015 Recommendation for Chamber Quantification Guidelines. Clinical Cardiology (2024).