The 2016 Diastolic Function Guideline

Oh, Jae K.; Miranda, William R.; Bird, Jared G.; Kane, Garvan C.; Nagueh, Sherif F.

doi:10.1016/j.jcmg.2019.12.004

Cited by 57 publications

(20 citation statements)

References 20 publications

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“…To test multi-variable approach for identifying raised PCWP we evaluated an algorithm previously proposed in patients with both normal and reduced LVEF [ 7 ]. This algorithm used e’ < 10 cm/s, (lateral segment) E/e’ lateral > 12, TR velocity > 2.8 m/s and LAVI > 34 ml/m 2 .…”

Section: Resultsmentioning

confidence: 99%

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Left atrial strain rate during atrial contraction predicts raised pulmonary capillary wedge pressure: evidence for left atrio-ventricular interaction

Lindqvist

Henein

2021

Int J Cardiovasc Imaging

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This study aimed to assess the relationship between different LA strain components and PCWP as well as to the relationship with other established methods. We studied 144 symptomatic patients, age 63 ± 14 years, 54 males, using conventional transthoracic echocardiography protocols, including LA and LV myocardial deformation from speckle tracking technique investigations along with simultaneous right heart catheterization (RHC) using established techniques. From RHC, pulmonary artery pressure (PAP), and pulmonary capillary wedge pressure (PCWP) were measured and pulmonary vascular resistance (PVR) calculated. LA strain rate during atrial contraction (LASRa) was the strongest correlate with PCWP (r2 = − 0.40, p < 0.001), over and above both LASR during LV systole (LASRs) and LA longitudinal strain during ventricular systole (LASs) (r2 = 0.21 and 0.19, respectively, p < 0.001 for both). The correlation between LASRa and PCWP was stronger in patients with post-capillary PH compared to pre-capillary PH (r2 = 0.21 vs. r2 = 0.02, respectively). The strongest relationship between LASRa and PCWP was in patients with enlarged LA volume > 34 ml/m2 (r2 = 0.60, p < 0.001). In all patients LASRa < = 0.9 1/s was 88% accurate in predicting LA pressure > 15 mmHg which was superior to recently proposed uni- and multi-variable models. LASR during atrial contraction is the strongest predictor of PCWP, particularly in patients with post-capillary PH and with dilated LA cavity. Furthermore, it proved superior to recently proposed uni- and multi-variable based algorithms. Its close relationship with LV strain rate counterpart reflects important left heart chamber interaction in patients with raised LA pressure.

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Section: Resultsmentioning

confidence: 99%

“…However, Doppler parameters can sometimes be only modestly accurate in estimating LAP [ 5 ] even when combined with myocardial velocities. [ 6 ] To overcome single measurement limitation in estimating PCWP a multi-variable algorithm has been proposed in recent guidelines [ 3 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

Left atrial strain rate during atrial contraction predicts raised pulmonary capillary wedge pressure: evidence for left atrio-ventricular interaction

Lindqvist

Henein

2021

Int J Cardiovasc Imaging

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“…On the other hand, apart from diagnosing diastolic dysfunction (including preclinical diastolic dysfunction), the 2016 ASE/EACVI criteria enable its grading with an estimation of LA pressure, which, although not very accurate, is very useful in clinical practice, especially for follow-up of HF patients and assessment of efficacy of diuretic treatment. Notably, this year, a modification of the 2016 ASE/ /EACVI algorithm was proposed by two of its authors, however, not as official recommendations [67]. .…”

Section: Are the 2019 Hfa-peff Score And The 2016 Ase/eacvi Algorithmmentioning

confidence: 99%

On the search for the right definition of heart failure with preserved ejection fraction

et al. 2020

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The definition of heart failure with preserved ejection fraction (HFpEF) has evolved from a clinically based "diagnosis of exclusion" to definitions focused on objective evidence of diastolic dysfunction and/ /or elevated left ventricular filling pressures. Despite advances in our understanding of HFpEF pathophysiology and the development of more sophisticated imaging modalities, the diagnosis of HFpEF remains challenging, especially in the chronic setting, given that symptoms are provoked by exertion and diagnostic evaluation is largely conducted at rest. Invasive hemodynamic study, and in particularinvasive exercise testing, is considered the reference method for HFpEF diagnosis. However, its use is limited as opposed to the high number of patients with suspected HFpEF. Thus, diagnostic criteria for HFpEF should be principally based on non-invasive measurements. As no single non-invasive variable can adequately corroborate or refute the diagnosis, different combinations of clinical, echocardiographic, and/or biochemical parameters have been introduced. Recent years have brought an abundance of HF-pEF definitions. Here, we present and compare four of them: 1) the 2016 European Society of Cardiology criteria for HFpEF; 2) the 2016 echocardiographic algorithm for diagnosing diastolic dysfunction; 3) the 2018 evidence-based H 2 FPEF score; and 4) the most recent, 2019 Heart Failure Association HFA-PEFF algorithm. These definitions vary in their approach to diagnosis, as well as sensitivity and specificity. Further studies to validate and compare the diagnostic accuracy of HFpEF definitions are warranted. Nevertheless, it seems that the best HFpEF definition would originate from a randomized clinical trial showing a favorable effect of an intervention on prognosis in HFpEF.

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“…Four LVDF parameters (septal e ′ ≥ 7 cm/s, septal E/e ′ ≤ 15, TR velocity ≤ 2.8 m/s, and LAVI ≤ 34 ml/m 2 ) were used for LVDF scoring (7). The presence of each abnormal LVDF parameter was scored as 1, and the total LVDF score ranged from 0 to 4 (normal filling pressure: LVDF score 0-1, indeterminate: LVDF score 2, increased filling pressure: LVDF score 3-4).…”

Section: Echocardiographic Data and Study Definitionmentioning

confidence: 99%

“…Recently, Oh et al proposed a simplified and unified algorithm for LVDF assessment (7). This algorithm benefited by simplifying the assessment in clinical practice and avoiding problems with discordance and false calls of diastolic dysfunction to achieve high specificity.…”

Section: Introductionmentioning

confidence: 99%

Usefulness of Diastolic Function Score as a Predictor of Long-Term Prognosis in Patients With Acute Myocardial Infarction

Bae

Yoon

Kim

et al. 2021

Front. Cardiovasc. Med.

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Background: Left ventricular diastolic function (LVDF) evaluation using a combination of several echocardiographic parameters is an important predictor of adverse events in patients with acute myocardial infarction (AMI). To date, the clinical impact of each individual LVDF marker is well-known, but the clinical significance of the sum of the abnormal diastolic function markers and the long-term clinical outcome are not well-known. This study aimed to investigate the usefulness of LVDF score in predicting clinical outcomes of patients with AMI.Methods: LVDF scores were measured in a 2,030 patients with AMI who underwent successful percutaneous coronary intervention from 2012 to 2015. Four LVDF parameters (septal e′ ≥ 7 cm/s, septal E/e′ ≤ 15, TR velocity ≤ 2.8 m/s, and LAVI ≤ 34 ml/m2) were used for LVDF scoring. The presence of each abnormal LVDF parameter was scored as 1, and the total LVDF score ranged from 0 to 4. Mortality and hospitalization due to heart failure (HHF) in relation to LVDF score were evaluated. To compare the predictive ability of LVDF scores and left ventricular ejection fraction (LVEF) for mortality and HHF, receiver operating characteristic (ROC) curve and landmark analyses were performed.Results: Over the 3-year clinical follow-up, all-cause mortality occurred in 278 patients (13.7%), while 91 patients (4.5%) developed HHF. All-cause mortality and HHF significantly increased as LVDF scores increased (all-cause mortality–LVDF score 0: 2.3%, score 1: 8.8%, score 2: 16.7%, score 3: 31.8%, and score 4: 44.5%, p < 0.001; HHF–LVDF score 0: 0.6%, score 1: 1.8%, score 2: 6.3%, score 3: 10.3%, and score 4: 18.2%, p < 0.001). In multivariate analysis, a higher LVDF score was associated with significantly higher adjusted hazard ratios for all-cause mortality and HHF. In landmark analysis, LVDF score was a better predictor of long-term mortality than LVEF (area under the ROC curve: 0.739 vs. 0.640, p < 0.001).Conclusion: The present study demonstrated that LVDF score was a significant predictor of mortality and HHF in patients with AMI. LVDF scores are useful for risk stratification of patients with AMI; therefore, careful monitoring and management should be performed for patients with AMI with higher LVDF scores.

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The 2016 Diastolic Function Guideline

Cited by 57 publications

References 20 publications

Left atrial strain rate during atrial contraction predicts raised pulmonary capillary wedge pressure: evidence for left atrio-ventricular interaction

Left atrial strain rate during atrial contraction predicts raised pulmonary capillary wedge pressure: evidence for left atrio-ventricular interaction

On the search for the right definition of heart failure with preserved ejection fraction

Usefulness of Diastolic Function Score as a Predictor of Long-Term Prognosis in Patients With Acute Myocardial Infarction

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