The 2016 ASE/EACVI recommendations yielded a significantly lower prevalence of diastolic dysfunction than the 2009 ASE recommendations (9.4% vs. 16.8%, p < 0.001) in patients with preserved EF.
Cross-Sectional (n=500)
Does the use of the 2016 ASE/EACVI recommendations compared to the 2009 ASE recommendations alter the prevalence of diastolic dysfunction and abnormal LV filling pressures in patients with preserved EF?
The 2016 ASE/EACVI recommendations result in a significantly lower prevalence of diagnosed diastolic dysfunction and abnormal LV filling pressures compared to the 2009 guidelines in patients with preserved EF.
Absolute Event Rate: 9.4% vs 16.8%
p-value: p=< 0.001
BACKGROUND: Assessment of diastolic dysfunction (DD) and left ventricular filling pressures (LVFP) by echocardiography is complex in patients with preserved ejection fraction (EF). The American Society of Echocardiography and the European Association of Cardiovascular Imaging (ASE/EACVI) jointly published recommendations in 2016 to simplify the diagnosis and classification of DD and the assessment of LVFP. We aimed to study the impact of the updated 2016 ASE/EACVI guidelines vis-à-vis the 2009 ASE recommendations on prevalence of DD and LVFP in patients with preserved EF. METHODS: Five hundred patients referred to the echocardiography laboratory from March 2020 to May 2020 were analyzed. Patients with left ventricular ejection fraction (LVEF) < 50% were excluded. All patients underwent comprehensive transthoracic echocardiography. DD and LVFP were assessed by the 2016 ASE/EACVI and 2009 ASE recommendations. The concordance between the guidelines was analyzed by kappa coefficient and overall proportion of agreement. RESULTS: Mean age was 53 ± 13 years and 63.4% were men. Prevalence of DD and abnormal LVFP were significantly lower with the 2016 recommendations than with the 2009 recommendations (9.4% vs. 16.8%, p < 0.001 and 8.4% vs. 12.8%, p < 0.05). Patients with Grade 1 DD (100%) and Grade 2 DD (46.4%) were reclassified by the 2016 recommendations. Indeterminate diastolic function (9.8%) was strikingly high according to the 2016 recommendations. The concordance between the two recommendations was moderate (kappa = 0.569). The overall proportion of agreement was 85.4%. CONCLUSIONS: Prevalence of DD and abnormal LV filling pressures were lower with application of the 2016 ASE/EACVI recommendations in patients with preserved EF. There was moderate agreement between the 2009 and 2016 recommendations.
S et al. (2020) conducted a cross-sectional in Preserved ejection fraction (n=500). 2016 ASE/EACVI recommendations vs. 2009 ASE recommendations was evaluated on Prevalence of diastolic dysfunction (p=< 0.001). The 2016 ASE/EACVI recommendations yielded a significantly lower prevalence of diastolic dysfunction than the 2009 ASE recommendations (9.4% vs. 16.8%, p < 0.001) in patients with preserved EF.