Impact of the 2016 ASE/EACVI recommendations on the prevalence of diastolic dysfunction in the general population

Almeida, João; Fontes‐Carvalho, Ricardo; Sampaio, Francisco; Ribeiro, José; Bettencourt, Paulo; Flachskampf, Frank A.; Leite‐Moreira, Adelino F.; Azevedo, Ana

doi:10.1093/ehjci/jex252

Cited by 128 publications

(114 citation statements)

References 27 publications

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“…Diastolic parameters in normal controls based on age have been published . The 2016 ASE guideline was created to make diastolic function simpler but is very specific for advanced diastolic dysfunction and increased the proportion of the patients with normal diastolic function in the general population . The Mayo Clinic echocardiography laboratory has proposed a revised, simpler diagnostic algorithm (Fig.…”

Section: Redefining Ccm Criteria: Alignment With Contemporary Metricsmentioning

confidence: 99%

Redefining Cirrhotic Cardiomyopathy for the Modern Era

et al. 2019

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Cirrhotic cardiomyopathy (CCM) is cardiac dysfunction in patients with end‐stage liver disease in the absence of prior heart disease. First defined in 2005 during the World Congress of Gastroenterology, CCM criteria consisted of echocardiographic parameters to identify subclinical cardiac dysfunction in the absence of overt structural abnormalities. Significant advancements in cardiovascular imaging over the past 14 years, including the integration of myocardial deformation imaging into routine clinical practice to identify subclinical cardiovascular dysfunction, have rendered the 2005 CCM criteria obsolete. Therefore, new criteria based on contemporary cardiovascular imaging parameters are needed. In this guidance document, assembled by a group of multidisciplinary experts in the field, new core criteria based on contemporary cardiovascular imaging parameters are proposed for the assessment of CCM. This document provides a critical assessment of the diagnosis of CCM and ongoing assessment aimed at improving clinical outcomes, particularly surrounding liver transplantation. Key points and practice‐based recommendations for the diagnosis of CCM are provided to offer guidance for clinicians and identify gaps in knowledge for future investigations.

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Section: Redefining Ccm Criteria: Alignment With Contemporary Metricsmentioning

confidence: 99%

Redefining Cirrhotic Cardiomyopathy for the Modern Era

et al. 2019

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“…On the other hand, a recent study [17] reported that the prevalence of the DD grade was 1.4% in the general population. The prevalence of DD in dialysis patients was found to be high.…”

Section: Discussion/conclusionmentioning

confidence: 97%

“…Furthermore, we did not evaluate the possible effects of the different medications used to treat hypertension on arterial stiffness and LVDD in the interpretation of our results. In addition, since there is currently no specific gold standard to diagnose LVDD, it was not possible to establish the diagnostic accuracy of the three different classifications in the general population [17] or hemodialysis patients in the present study. This classification may only have the ability to detect the most advanced cases [17].…”

Section: Discussion/conclusionmentioning

confidence: 97%

“…In addition, since there is currently no specific gold standard to diagnose LVDD, it was not possible to establish the diagnostic accuracy of the three different classifications in the general population [17] or hemodialysis patients in the present study. This classification may only have the ability to detect the most advanced cases [17]. Many of our hemodialysis subjects were classified as “indeterminate.” Further studies are needed to clarify whether this tendency is specific to hemodialysis patients.…”

Section: Discussion/conclusionmentioning

confidence: 97%

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Grading of Left Ventricular Diastolic Dysfunction with Preserved Systolic Function by the 2016 American Society of Echocardiography/European Association of Cardiovascular Imaging Recommendations Contributes to Predicting Cardiovascular Events in Hemodialysis Patients

Toida¹,

Toida

Yamashita

et al. 2019

Cardiorenal Med

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Background: Left ventricular diastolic dysfunction (LVDD) causes heart failure with a preserved left ventricular ejection fraction (LVEF) in the general population. Objective: To examine the relationships between the LVDD grades of the 2016 American Society of Echocardiography/European Association of Cardiovascular Imaging (ASE/EACVI) recommendations and several arteriosclerotic parameters and major cardiovascular events (MACE) in hemodialysis patients with preserved LVEF. Method: Sixty-three prevalent hemodialysis patients (median age [interquartile range], 69 [64–75] years, 31.7% female) with normal systolic function (LVEF > 50%) were enrolled. LVDD evaluated by echocardiography at baseline was divided into three groups according to ASE/EACVI recommendations (normal diastolic function [ND], n = 24; intermediate, n = 19; diastolic dysfunction [DD], n = 20). All patients underwent analyses of several arteriosclerotic parameters (carotid intima-media thickness [CIMT], plaque score [PS], ankle brachial index [ABI], and brachial-ankle pulse wave velocity [baPWV]). The presence or absence of postdialysis orthostatic hypotension was assessed in each dialysis session. MACE during the 1-year follow-up period was obtained from medical records. Kaplan-Meier and Cox’s regression analyses were used to investigate the relationship between LVDD grades and MACE. Results: Postdialysis orthostatic hypotension and PS, but not CIMT, ABI, or baPWV, increased proportionally with LVDD grades. Eleven patients developed MACE, including 2 cardiovascular deaths. The Kaplan-Meier analysis showed that MACE frequently occurred in the DD grade (p = 0.002 by the log-rank test). Cox’s regression analysis adjusted for potential confounders (age, sex, diabetes, systolic blood pressure, and body mass index) revealed that the DD grade was associated with MACE when the ND grade was set as a reference. Conclusions: In maintenance hemodialysis patients with normal ventricular systolic function, a classification of LVDD by the 2016 ASE/EACVI recommendations may be a useful tool for predicting cardiovascular events.

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“…Furthermore, retrospective studies have highlighted that the new recommendations may be too restrictive and only capable of identifying advanced diastolic dysfunction 20 . The model is arguably more restrictive as the variables and cutoff values are selected with a high emphasis on specificity and seek to avoid false positive classifications.…”

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confidence: 99%

Diastolic function recommendations: Are we too relaxed when reporting myocardial relaxation?

Olsen

2020

Echocardiography

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Impact of the 2016 ASE/EACVI recommendations on the prevalence of diastolic dysfunction in the general population

Abstract: 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.

Cited by 128 publications

References 27 publications

Redefining Cirrhotic Cardiomyopathy for the Modern Era

Redefining Cirrhotic Cardiomyopathy for the Modern Era

Grading of Left Ventricular Diastolic Dysfunction with Preserved Systolic Function by the 2016 American Society of Echocardiography/European Association of Cardiovascular Imaging Recommendations Contributes to Predicting Cardiovascular Events in Hemodialysis Patients

Diastolic function recommendations: Are we too relaxed when reporting myocardial relaxation?

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