Literature DB >> 31619369

Practical Impact of New Diastolic Recommendations on Noninvasive Estimation of Left Ventricular Diastolic Function and Filling Pressures.

Regina Sorrentino1, Roberta Esposito1, Ciro Santoro1, Andrea Vaccaro2, Sara Cocozza2, Maria Scalamogna1, Maria Lembo1, Federica Luciano2, Alessandro Santoro1, Bruno Trimarco1, Maurizio Galderisi3.   

Abstract

BACKGROUND: In 2016, an update of the 2009 recommendations for the evaluation of left ventricular (LV) diastolic function (DF) was released by the American Society of Echocardiography and the European Association of Cardiovascular Imaging. The aims of this study were to assess the concordance between the 2016 and 2009 recommendations and to test the impact of the consideration of "myocardial disease" recommended in the 2016 update on the evaluation of diastolic dysfunction (DD) and LV filling pressures in patients with normal and reduced LV ejection fractions referred to a general echocardiography laboratory.
METHODS: A total of 1,508 outpatients referred to an echocardiography laboratory during a predefined 5-month period were prospectively enrolled. All patients underwent targeted clinical history and Doppler echocardiographic examination. DD and LV filling pressures were assessed according to 2009 and 2016 recommendations. Concordance was calculated using the κ coefficient and overall proportion of agreement.
RESULTS: Overall proportion of agreement between the two recommendations was 64.7% (κ = 0.43). Comparing the 2009 and 2016 recommendations, 47.5% and 36.1% patients, respectively, had DD (P < .0001), and 22.7% and 12.6% had elevated LV filling pressures (P < .0001). This difference remained significant in the setting of patients with normal LV ejection fractions (21.6% vs 10.7%, P < .0001). In the application of the 2016 recommendations, whether or not the presence of "myocardial disease" was considered, the prevalence of indeterminate diastolic function was, respectively, 7.3% versus 13.7%, while patients in whom the DD grade could not be determined were 8.1% versus 14.4% (P < .0001 for all).
CONCLUSIONS: Considering the presence of myocardial disease when applying the 2016 recommendations resulted in a lower prevalence of inconclusive diagnosis.
Copyright © 2019 American Society of Echocardiography. Published by Elsevier Inc. All rights reserved.

Entities:  

Keywords:  Diastolic function; Doppler echocardiography; Left ventricular filling pressures; Myocardial disease; Recommendations

Mesh:

Year:  2019        PMID: 31619369     DOI: 10.1016/j.echo.2019.08.013

Source DB:  PubMed          Journal:  J Am Soc Echocardiogr        ISSN: 0894-7317            Impact factor:   5.251


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