ABSTRACT
A further aspect relevant to investigation
has emerged recently with the recognition that
it is possible to retard or even prevent the
development of heart failure. Although
chronic heart failure can arise acutely
following a major left ventricular insult, the
usual onset is more insidious, and often
preceded by a latent phase of asymptomatic or
minimally symptomatic left ventricular
dysfunction. Studies show that the natural
history of left ventricular dysfunction is one of
relentless deterioration, even without
additional ventricular damage.1 However, the
rate of progression can be reduced with early
recognition and appropriate drug treatment
using ACE inhibitors1 and perhaps also
-blockers.2 The implication is that we need
to consider strategies for population screening
in order to identify ‘at risk’ individuals who
by definition are unlikely to come to medical
attention spontaneously. The potential
importance of this problem is illustrated by
recent work showing that the prevalence of
asymptomatic left ventricular dysfunction is
likely to be at least as high as that of overt
The purpose of this chapter is to review
the most important investigations available to
physicians who manage heart failure, and also
to attempt to offer an insight into some of the
latest techniques currently being developed.
