Impact of Updated 2016 ASE/EACVI VIS-A-VIS 2009 ASE Recommendation on the Prevalence of Diastolic Dysfunction and LV Filling Pressures in Patients with Preserved Ejection Fraction

Sunil Kumar S; Nagaraj Desai; Oliver Joel Gona; Vinay Kumar K; Madhu B

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저자정보: Sunil Kumar S (JSS Academy of Higher Education and Research) Nagaraj Desai (JSS Academy of Higher Education and Research) Oliver Joel Gona (JSS Academy of Higher Education and Research) Vinay Kumar K (JSS Academy of Higher Education and Research) Madhu B (JSS Academy of Higher Education and Research)

저널정보: 한국심초음파학회 Journal of Cardiovascular Imaging Journal of Cardiovascular Imaging 제29권 제1호

발행연도: 2021.1

수록면: 31 - 43 (13page)

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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-a-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.

#Doppler echocardiography #Left ventricle #Diastole #Dysfunction #Heart failure #Guidelines

참고문헌 (38)

참고문헌 신청

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