The 2016 ASE/EACVI recommendations yielded a much lower prevalence of diastolic dysfunction (1.4%) compared to the 2009 guidelines (38.1%) and Canberra Study Criteria (30.4%).
Cohort (n=1,000)
Does the application of the 2016 ASE/EACVI recommendations alter the prevalence and grading of diastolic dysfunction compared to previous guidelines in the general population?
The 2016 ASE/EACVI recommendations significantly reduce the diagnosed prevalence of diastolic dysfunction in the general population compared to previous criteria, likely identifying only the most advanced cases.
Absolute Event Rate: 1.4% vs 38.1%
p-value: p=<0.001
Aims: Diastolic dysfunction (DD) is frequent in the general population; however, the assessment of diastolic function remains challenging. We aimed to evaluate the impact of the recent 2016 American Society of Echocardiography (ASE)/European Association of Cardiovascular Imaging (EACVI) recommendations in the prevalence and grades of DD compared with the 2009 guidelines and the Canberra Study Criteria (CSC). Methods and results: Within a population-based cohort, a total of 1000 individuals, aged ≥45 years, were evaluated retrospectively. Patients with previously known cardiac disease or ejection fraction <50% were excluded. Diastolic function was assessed by transthoracic echocardiography. DD prevalence and grades were determined according to the three classifications. The mean age was 62.0 ± 10.5 years and 37% were men. The prevalence of DD was 1.4% (n = 14) with the 2016 recommendations, 38.1% (n = 381) with the 2009 recommendations, and 30.4% (n = 304) using the CSC. The concordance between the updated recommendations and the other two was poor (from k = 0.13 to k = 0.18, P < 0.001). Regarding the categorization in DD grades, none of the 14 individuals with DD by the 2016 guidelines were assigned to Grade 1 DD, 64% were classified as Grade 2, 7% had Grade 3, and 29% had indeterminate grade. Conclusion: The application of the new 2016 ASE/EACVI recommendations resulted in a much lower prevalence of DD. The concordance between the classifications was poor. The updated algorithm seems to be able to diagnose only the most advanced cases.
Almeida et al. (2017) conducted a cohort in Diastolic dysfunction (n=1,000). 2016 ASE/EACVI recommendations vs. 2009 guidelines and Canberra Study Criteria (CSC) was evaluated on Prevalence of diastolic dysfunction (p=<0.001). The 2016 ASE/EACVI recommendations yielded a much lower prevalence of diastolic dysfunction (1.4%) compared to the 2009 guidelines (38.1%) and Canberra Study Criteria (30.4%).