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Current Cardiovascular Imaging Reports
Erschienen in: Current Cardiovascular Imaging Reports 12/2018

01.12.2018 | Echocardiography (F Asch and S Costa, Section Editors)

Diastolic Assessment: Application of the New ASE Guidelines

verfasst von: Abhinav Sharma, Allan L. Klein

Erschienen in: Current Cardiovascular Imaging Reports | Ausgabe 12/2018

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Abstract

Purpose of Review

The purpose of this review is to summarize the new guidelines from the American Society of Echocardiography (ASE) and the European Association of Cardiovascular Imaging (EACVI) for the diagnosis and grading of diastolic dysfunction (DD), with commentary on the rationale behind the use of the recommended individual parameters.

Recent Findings

Previous guidelines for assessment of diastolic function have been criticized for being too complex with modest diagnostic performance and inter-observer variability.

Summary

The new ASE/EACVI diastology guidelines aim to simplify the diagnosis and gradation of DD by using a limited set of echocardiographic variables. The robustness of these recommendations has been subsequently validated in several trials. Understanding the physiological principles that govern changes in echocardiographic parameters during normal and abnormal diastolic function is critical for the appropriate application of these recommendations.
Literatur
1.
Unzek S, Popovic ZB, Marwick TH, Investigators DGC. Effect of recommendations on interobserver consistency of diastolic function evaluation. JACC Cardiovasc Imaging. 2011;4(5):460–7.CrossRef
2.
Nagueh SF, Appleton CP, Gillebert TC, Marino PN, Oh JK, Smiseth OA, et al. Recommendations for the evaluation of left ventricular diastolic function by echocardiography. Eur J Echocardiogr. 2009;10(2):165–93.CrossRef
3.
Benjamin EJ, Blaha MJ, Chiuve SE, Cushman M, Das SR, Deo R, et al. Heart Disease and Stroke Statistics-2017 update: a report from the American Heart Association. Circulation. 2017;135(10):e146–603.CrossRef
4.
Gerber Y, Weston SA, Redfield MM, Chamberlain AM, Manemann SM, Jiang R, et al. A contemporary appraisal of the heart failure epidemic in Olmsted County, Minnesota, 2000 to 2010. JAMA Intern Med. 2015;175(6):996–1004.CrossRef
5.
Yancy CW, Jessup M, Bozkurt B, Butler J, Casey DE, Drazner MH, et al. 2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation/American Heart Association task force on practice guidelines. J Am Coll Cardiol. 2013;62(16):e147–239.CrossRef
6.
Bursi F, Weston SA, Redfield MM, Jacobsen SJ, Pakhomov S, Nkomo VT, et al. Systolic and diastolic heart failure in the community. JAMA. 2006;296(18):2209–16.CrossRef
7.
Chang PP, Chambless LE, Shahar E, Bertoni AG, Russell SD, Ni H, et al. Incidence and survival of hospitalized acute decompensated heart failure in four US communities (from the Atherosclerosis Risk in Communities Study). Am J Cardiol. 2014;113(3):504–10.CrossRef
8.
Lam CS, Lyass A, Kraigher-Krainer E, Massaro JM, Lee DS, Ho JE, et al. Cardiac dysfunction and noncardiac dysfunction as precursors of heart failure with reduced and preserved ejection fraction in the community. Circulation. 2011;124(1):24–30.CrossRef
9.
Yeboah J, Rodriguez CJ, Stacey B, Lima JA, Liu S, Carr JJ, et al. Prognosis of individuals with asymptomatic left ventricular systolic dysfunction in the multi-ethnic study of atherosclerosis (MESA). Circulation. 2012;126(23):2713–9.CrossRef
10.
Mullens W, Borowski AG, Curtin RJ, Thomas JD, Tang WH. Tissue Doppler imaging in the estimation of intracardiac filling pressure in decompensated patients with advanced systolic heart failure. Circulation. 2009;119(1):62–70.CrossRef
11.
Grant AD, Negishi K, Negishi T, Collier P, Kapadia SR, Thomas JD, et al. Grading diastolic function by echocardiography: hemodynamic validation of existing guidelines. Cardiovasc Ultrasound. 2015;13:28.CrossRef
12.
Shah AM, Claggett B, Kitzman D, Biering-Sørensen T, Jensen JS, Cheng S, et al. Contemporary assessment of left ventricular diastolic function in older adults: the atherosclerosis risk in communities study. Circulation. 2017;135(5):426–39.CrossRef
13.
Selmeryd J, Henriksen E, Leppert J, Hedberg P. Interstudy heterogeneity of definitions of diastolic dysfunction severely affects reported prevalence. Eur Heart J Cardiovasc Imaging. 2016;17(8):892–9.CrossRef
14.
Nagueh SF, Smiseth OA, Appleton CP, Byrd BF, Dokainish H, Edvardsen T, et al. Recommendations for the evaluation of left ventricular diastolic function by echocardiography: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr. 2016;29(4):277–314.CrossRef
15.
Rohde LE, Palombini DV, Polanczyk CA, Goldraich LA, Clausell N. A hemodynamically oriented echocardiography-based strategy in the treatment of congestive heart failure. J Card Fail. 2007;13(8):618–25.CrossRef
16.
Ishida Y, Meisner JS, Tsujioka K, Gallo JI, Yoran C, Frater RW, et al. Left ventricular filling dynamics: influence of left ventricular relaxation and left atrial pressure. Circulation. 1986;74(1):187–96.CrossRef
17.
Takagi S, Yokota M, Iwase M, Yoshida J, Hayashi H, Sotobata I, et al. The important role of left ventricular relaxation and left atrial pressure in the left ventricular filling velocity profile. Am Heart J. 1989;118(5 Pt 1):954–62.CrossRef
18.
Caballero L, Kou S, Dulgheru R, Gonjilashvili N, Athanassopoulos GD, Barone D, et al. Echocardiographic reference ranges for normal cardiac Doppler data: results from the NORRE study. Eur Heart J Cardiovasc Imaging. 2015;16(9):1031–41.PubMed
19.
Ommen SR, Nishimura RA, Appleton CP, Miller FA, Oh JK, Redfield MM, et al. Clinical utility of Doppler echocardiography and tissue Doppler imaging in the estimation of left ventricular filling pressures: a comparative simultaneous Doppler-catheterization study. Circulation. 2000;102(15):1788–94.CrossRef
20.
Tsang TS, Barnes ME, Gersh BJ, Bailey KR, Seward JB. Left atrial volume as a morphophysiologic expression of left ventricular diastolic dysfunction and relation to cardiovascular risk burden. Am J Cardiol. 2002;90(12):1284–9.CrossRef
21.
Lang RM, Badano LP, Mor-Avi V, Afilalo J, Armstrong A, Ernande L, et al. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr. 2015;28(1):1–39.e14.CrossRef
22.
Kosmala W, Jellis CL, Marwick TH. Exercise limitation associated with asymptomatic left ventricular impairment: analogy with stage B heart failure. J Am Coll Cardiol. 2015;65(3):257–66.CrossRef
23.
Peterson KL, Tsuji J, Johnson A, DiDonna J, LeWinter M. Diastolic left ventricular pressure-volume and stress-strain relations in patients with valvular aortic stenosis and left ventricular hypertrophy. Circulation. 1978;58(1):77–89.CrossRef
24.
Pai RG, Gill KS. Amplitudes, durations, and timings of apically directed left ventricular myocardial velocities: II. Systolic and diastolic asynchrony in patients with left ventricular hypertrophy. J Am Soc Echocardiogr. 1998;11(2):112–8.CrossRef
25.
De Marchi SF, Allemann Y, Seiler C. Relaxation in hypertrophic cardiomyopathy and hypertensive heart disease: relations between hypertrophy and diastolic function. Heart. 2000;83(6):678–84.CrossRef
26.
Lam CS, Roger VL, Rodeheffer RJ, Borlaug BA, Enders FT, Redfield MM. Pulmonary hypertension in heart failure with preserved ejection fraction: a community-based study. J Am Coll Cardiol. 2009;53(13):1119–26.CrossRef
27.
Badesch DB, Champion HC, Sanchez MA, Hoeper MM, Loyd JE, Manes A, et al. Diagnosis and assessment of pulmonary arterial hypertension. J Am Coll Cardiol. 2009;54(1 Suppl):S55–66.CrossRef
28.
Lam CS, Borlaug BA, Kane GC, Enders FT, Rodeheffer RJ, Redfield MM. Age-associated increases in pulmonary artery systolic pressure in the general population. Circulation. 2009;119(20):2663–70.CrossRef
29.
Rudski LG, Lai WW, Afilalo J, Hua L, Handschumacher MD, Chandrasekaran K, et al. Guidelines for the echocardiographic assessment of the right heart in adults: a report from the American Society of Echocardiography endorsed by the European Association of Echocardiography, a registered branch of the European Society of Cardiology, and the Canadian Society of Echocardiography. J Am Soc Echocardiogr. 2010;23(7):685–713 quiz 86–8.CrossRef
30.
• Firstenberg MS, Levine BD, Garcia MJ, Greenberg NL, Cardon L, Morehead AJ, et al. Relationship of echocardiographic indices to pulmonary capillary wedge pressures in healthy volunteers. J Am Coll Cardiol. 2000;36(5):1664–9 This paper showed that E / A does not perform well in patients without heart disease. CrossRef
31.
Oh JK, Appleton CP, Hatle LK, Nishimura RA, Seward JB, Tajik AJ. The noninvasive assessment of left ventricular diastolic function with two-dimensional and Doppler echocardiography. J Am Soc Echocardiogr. 1997;10(3):246–70.CrossRef
32.
Nagueh SF, Kopelen HA, Quiñones MA. Assessment of left ventricular filling pressures by Doppler in the presence of atrial fibrillation. Circulation. 1996;94(9):2138–45.CrossRef
33.
Temporelli PL, Scapellato F, Corrà U, Eleuteri E, Imparato A, Giannuzzi P. Estimation of pulmonary wedge pressure by transmitral Doppler in patients with chronic heart failure and atrial fibrillation. Am J Cardiol. 1999;83(5):724–7.CrossRef
34.
Yamamoto K, Nishimura RA, Chaliki HP, Appleton CP, Holmes DR, Redfield MM. Determination of left ventricular filling pressure by Doppler echocardiography in patients with coronary artery disease: critical role of left ventricular systolic function. J Am Coll Cardiol. 1997;30(7):1819–26.CrossRef
35.
Nishimura RA, Appleton CP, Redfield MM, Ilstrup DM, Holmes DR, Tajik AJ. Noninvasive doppler echocardiographic evaluation of left ventricular filling pressures in patients with cardiomyopathies: a simultaneous Doppler echocardiographic and cardiac catheterization study. J Am Coll Cardiol. 1996;28(5):1226–33.CrossRef
36.
Nagueh SF, Lakkis NM, Middleton KJ, Spencer WH, Zoghbi WA, Quiñones MA. Doppler estimation of left ventricular filling pressures in patients with hypertrophic cardiomyopathy. Circulation. 1999;99(2):254–61.CrossRef
37.
Ohno M, Cheng CP, Little WC. Mechanism of altered patterns of left ventricular filling during the development of congestive heart failure. Circulation. 1994;89(5):2241–50.CrossRef
38.
Klein AL, Tajik AJ. Doppler assessment of pulmonary venous flow in healthy subjects and in patients with heart disease. J Am Soc Echocardiogr. 1991;4(4):379–92.CrossRef
39.
Klein AL, Burstow DJ, Tajik AJ, Zachariah PK, Bailey KR, Seward JB. Effects of age on left ventricular dimensions and filling dynamics in 117 normal persons. Mayo Clin Proc. 1994;69(3):212–24.CrossRef
40.
Nishimura RA, Abel MD, Hatle LK, Tajik AJ. Assessment of diastolic function of the heart: background and current applications of Doppler echocardiography. Part II. Clinical studies. Mayo Clin Proc. 1989;64(2):181–204.CrossRef
41.
Rivas-Gotz C, Khoury DS, Manolios M, Rao L, Kopelen HA, Nagueh SF. Time interval between onset of mitral inflow and onset of early diastolic velocity by tissue Doppler: a novel index of left ventricular relaxation: experimental studies and clinical application. J Am Coll Cardiol. 2003;42(8):1463–70.CrossRef
42.
Brun P, Tribouilloy C, Duval AM, Iserin L, Meguira A, Pelle G, et al. Left ventricular flow propagation during early filling is related to wall relaxation: a color M-mode Doppler analysis. J Am Coll Cardiol. 1992;20(2):420–32.CrossRef
43.
Stugaard M, Smiseth OA, Risöe C, Ihlen H. Intraventricular early diastolic filling during acute myocardial ischemia, assessment by multigated color m-mode Doppler echocardiography. Circulation. 1993;88(6):2705–13.CrossRef
44.
Steine K, Stugaard M, Smiseth OA. Mechanisms of retarded apical filling in acute ischemic left ventricular failure. Circulation. 1999;99(15):2048–54.CrossRef
45.
Rovner A, de las Fuentes L, Waggoner AD, Memon N, Chohan R, Dávila-Román VG. Characterization of left ventricular diastolic function in hypertension by use of Doppler tissue imaging and color M-mode techniques. J Am Soc Echocardiogr. 2006;19(7):872–9.CrossRef
46.
Ohte N, Narita H, Akita S, Kurokawa K, Hayano J, Kimura G. Striking effect of left ventricular systolic performance on propagation velocity of left ventricular early diastolic filling flow. J Am Soc Echocardiogr. 2001;14(11):1070–4.CrossRef
47.
De Boeck BW, Oh JK, Vandervoort PM, Vierendeels JA, van der Aa RP, Cramer MJ. Colour M-mode velocity propagation: a glance at intra-ventricular pressure gradients and early diastolic ventricular performance. Eur J Heart Fail. 2005;7(1):19–28.CrossRef
48.
Garcia MJ, Ares MA, Asher C, Rodriguez L, Vandervoort P, Thomas JD. An index of early left ventricular filling that combined with pulsed Doppler peak E velocity may estimate capillary wedge pressure. J Am Coll Cardiol. 1997;29(2):448–54.CrossRef
49.
Rivas-Gotz C, Manolios M, Thohan V, Nagueh SF. Impact of left ventricular ejection fraction on estimation of left ventricular filling pressures using tissue Doppler and flow propagation velocity. Am J Cardiol. 2003;91(6):780–4.CrossRef
50.
• Andersen OS, Smiseth OA, Dokainish H, Abudiab MM, Schutt RC, Kumar A, et al. Estimating left ventricular filling pressure by echocardiography. J Am Coll Cardiol. 2017;69(15):1937–48 This paper validated the 2016 diastology guidelines by showing that the new recommendations had incremental diagnostic value over clinical assessment of heart failure. CrossRef
51.
• Sato K, ADM G, Negishi K, Cremer PC, Negishi T, Kumar A, et al. Reliability of updated left ventricular diastolic function recommendations in predicting elevated left ventricular filling pressure and prognosis. Am Heart J. 2017;189:28–39 This validation study showed that the 2016 diastology guidelines are superior to the 2009 guidelines in predicting LVEDP > 16 mmHg in patients with normal LVEF. CrossRef
52.
• Lancellotti P, Galderisi M, Edvardsen T, Donal E, Goliasch G, Cardim N, et al. Echo-Doppler estimation of left ventricular filling pressure: results of the multicentre EACVI Euro-Filling study. Eur Heart J Cardiovasc Imaging. 2017;18(9):961–8 This was the first multicenter study comparing the 2016 diastology guidelines to the 2009 guidelines and showed improved diagnostic performance of the 2016 guidelines over the 2009 recommendations. CrossRef
53.
Balaney B, Medvedofsky D, Mediratta A, Singh A, Ciszek B, Kruse E, et al. Invasive validation of the echocardiographic assessment of left ventricular filling pressures using the 2016 diastolic guidelines: head-to-head comparison with the 2009 guidelines. J Am Soc Echocardiogr. 2018;31(1):79–88.CrossRef
54.
• Diwan A, McCulloch M, Lawrie GM, Reardon MJ, Nagueh SF. Doppler estimation of left ventricular filling pressures in patients with mitral valve disease. Circulation. 2005;111(24):3281–9 This paper demonstrated the role of IVRT/T E-e′ in assessment of diastolic function in patients with mitral valve disease. CrossRef
55.
Bruch C, Stypmann J, Gradaus R, Breithardt G, Wichter T. Usefulness of tissue Doppler imaging for estimation of filling pressures in patients with primary or secondary pure mitral regurgitation. Am J Cardiol. 2004;93(3):324–8.CrossRef
56.
Abudiab MM, Chebrolu LH, Schutt RC, Nagueh SF, Zoghbi WA. Doppler echocardiography for the estimation of LV filling pressure in patients with mitral annular calcification. JACC Cardiovasc Imaging. 2017;10(12):1411–20.CrossRef
57.
Kusunose K, Yamada H, Nishio S, Tamai R, Niki T, Yamaguchi K, et al. Interval from the onset of transmitral flow to annular velocity is a marker of LV filling pressure. JACC Cardiovasc Imaging. 2013;6(4):528–30.CrossRef
58.
Kusunose K, Yamada H, Nishio S, Tomita N, Niki T, Yamaguchi K, et al. Clinical utility of single-beat E/e' obtained by simultaneous recording of flow and tissue Doppler velocities in atrial fibrillation with preserved systolic function. JACC Cardiovasc Imaging. 2009;2(10):1147–56.CrossRef
59.
Flachskampf FA, Biering-Sørensen T, Solomon SD, Duvernoy O, Bjerner T, Smiseth OA. Cardiac imaging to evaluate left ventricular diastolic function. JACC Cardiovasc Imaging. 2015;8(9):1071–93.CrossRef
60.
Dokainish H, Sengupta R, Pillai M, Bobek J, Lakkis N. Usefulness of new diastolic strain and strain rate indexes for the estimation of left ventricular filling pressure. Am J Cardiol. 2008;101(10):1504–9.CrossRef
61.
Santos AB, Kraigher-Krainer E, Gupta DK, Claggett B, Zile MR, Pieske B, et al. Impaired left atrial function in heart failure with preserved ejection fraction. Eur J Heart Fail. 2014;16(10):1096–103.CrossRef
62.
Morris DA, Belyavskiy E, Aravind-Kumar R, Kropf M, Frydas A, Braunauer K, et al. Potential usefulness and clinical relevance of adding left atrial strain to left atrial volume index in the detection of left ventricular diastolic dysfunction. JACC Cardiovasc Imaging. 2017.
63.
• Singh A, Addetia K, Maffessanti F, Mor-Avi V, Lang RM. LA strain for categorization of LV diastolic dysfunction. JACC Cardiovasc Imaging. 2017;10(7):735–43 This paper demonstrated that LA strain worsens in a stepwise manner with worsening diastolic function. CrossRef
64.
Solomon SD, Biering-Sørensen T. LA strain when ejection fraction is preserved: a new measure of diastolic function? JACC Cardiovasc Imaging. 2017;10(7):744–6.CrossRef
Metadaten
Titel
Diastolic Assessment: Application of the New ASE Guidelines
verfasst von
Abhinav Sharma
Allan L. Klein
Publikationsdatum
01.12.2018
Verlag
Springer US
Erschienen in
Current Cardiovascular Imaging Reports / Ausgabe 12/2018
Print ISSN: 1941-9066
Elektronische ISSN: 1941-9074
DOI
https://doi.org/10.1007/s12410-018-9474-0

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