<![CDATA[Heart failure (HF) is a prevalent and complex clinical syndrome demanding accurate and timely diagnosis due to its high morbidity, mortality, and substantial healthcare burden worldwide. Echocardiography, as the premier non-invasive cardiac imaging modality, plays a central role not only in the initial diagnosis but also in longitudinal monitoring throughout the spectrum of HF. Traditionally, Left Ventricular Ejection Fraction (LVEF) has served as the cornerstone for HF classification into three key phenotypes—Heart Failure with reduced Ejection Fraction (HFrEF, LVEF ≤40%), mildly reduced Ejection Fraction (HFmrEF, LVEF 41–49%), and preserved Ejection Fraction (HFpEF, LVEF ≥50%). While this remains clinically essential, emerging evidence highlights significant limitations of relying solely on LVEF, particularly in the detection of early or subtle myocardial dysfunction. Advances in echocardiographic technology have shifted the field toward more refined and quantitative evaluation of cardiac performance. Techniques such as Global Longitudinal Strain (GLS), three-dimensional (3D) volumetric imaging, and Point-of-Care Ultrasound (POCUS) provide enhanced diagnostic precision and prognostic insight across diverse HF populations. The clinical application has proven particularly valuable in challenging scenarios including Acute Decompensated HF (ADHF), HF in individuals with Atrial Fibrillation (AF), and Cancer Therapy-Related Cardiac Dysfunction (CTRCD), where conventional methods are often insufficient. Recent scientific data strongly support the use of strain-based imaging for earlier detection of myocardial injury, more accurate risk stratification, and improved guidance of therapeutic decision-making, reinforcing the expanding and transformative role of echocardiography in contemporary HF care.]]>
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