Differential Clinical Implications of Current Recommendations for the Evaluation of Left Ventricular Diastolic Function by Echocardiography

Basal Ventricular Septal Hypertrophy in Systemic Hypertension

“…15 This was coupled with a higher proportion of patients demonstrating indeterminate diastolic dysfunction − a classification previously associated with intermediate diastolic impairment. 16 LA assessment in BSH showed a reduction in LA reservoir function compared with healthy controls, and a pronounced reduction in LA conduit together with an increase in LA contractile function compared with the non-BSH subgroup. LA functional compensatory mechanisms serve as acute regulators of LA performance in response to impairment of LV filling, 17,18 showing a decreased atrial conduit function coupled with a compensatory, augmented contractile function in early stages of LV filling impairment.…”

Impact of the 2016 ASE/EACVI Guidelines on diastolic function reporting in routine clinical practice

“…Improved heterogeneity for DD grades 2 and 3 in our provider‐specific analysis is indicative of the increased specificity of the 2016 guidelines for DD grades 2 or higher DD noted in previous studies 13,15,16. While most studies looked at the performance of the two guidelines in the same set of patients and at one point in time, we report for the first time the actual impact of guidelines change on reported disease burden among unselected patients during routine clinical practice over a span of 27 months.…”

“…The primary goal was “to simplify the approach and thus increase the utility of the guidelines in daily clinical practice” 12. Studies have shown the DF assessment based on 2016 update correlated better with filling pressures, when compared to 2009 guidelines 13‐16. A subsequent study showed the 2016 update had decreased sensitivity but improved specificity with similar overall accuracy (75%) in estimating LV filling pressures 17.…”

“…A subsequent study showed the 2016 update had decreased sensitivity but improved specificity with similar overall accuracy (75%) in estimating LV filling pressures 17. Studies also showed 2016 update correlated better with outcomes 14‐15,18. While studies have looked at the accuracy of 2016 guidelines in identifying elevated LV filling pressures (DD grade 2 or higher), its performance in categorizing patients with normal filling pressures into normal DF and DD grade 1 is less certain.…”

Диастолическая Дисфункция: От Открытия До Последних Обновлений

“…Nowadays, the term "diastolic dysfunction" is in use. Diastole is disturbed also in systolic HF and considered to be more stressing with further worsening of exercise intolerance and determines the prognosis and systolic contraction disturbances, so HF is a common entity with both phenotypes [4,5] The signs of myocardial DD are detected in people with almost any heart disease. Thus, in patients with arterial hypertension (AH), left ventricular diastolic dysfunction (LVDD) occurs in 50-90 % of cases and closely correlates with the degree of increase in blood pressure (BP) and AH presence.…”