Cardiovascular Institute, Hospital Clínic, Universitat de Barcelona, Villarroel 170, 08036 Barcelona, Spain.
Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain.
Eur Heart J Cardiovasc Imaging. 2021 Sep 20;22(10):1098-1105. doi: 10.1093/ehjci/jeab087.
The aim of this study is to analyse how current recommendations on left ventricular (LV) diastolic function assessment have been adopted. Identifying potential discrepancies between recommendations and everyday clinical practice would enable us to better understand and address the remaining challenges in this controversial and complex field.
A total of 93 centres, mainly from tertiary care settings, responded to the survey. More than three-quarters (77%) of centres follow the 2016 ASE/EACVI recommendations for LV diastolic function evaluation in patients with preserved ejection fraction based upon e', E/e', tricuspid regurgitation velocity, and left atrial (LA) volume. These recommendations were generally preferred to the previous 2009 version. Many centres also consider strain assessments in the LV (48%) and left atrium (53%) as well as diastolic stress echocardiography (33%) to be useful as additional assessments of LV diastolic function. Echocardiographic assessments of LV diastolic function were used frequently to guide therapy in 72% of centres.
There is widespread adoption of current recommendation on the evaluation of LV diastolic function and these are frequently used to guide patient management. Many centres now also consider LV and LA strain assessments useful in the clinical assessment of diastolic function. These may be considered in future recommendations.
本研究旨在分析当前左心室(LV)舒张功能评估建议的采用情况。识别建议与日常临床实践之间的潜在差异,将使我们能够更好地理解和解决这一具有争议且复杂领域中尚存的挑战。
共有 93 个中心,主要来自三级护理环境,对调查做出了回应。超过四分之三(77%)的中心根据 e'、E/e'、三尖瓣反流速度和左心房(LA)容积,遵循 2016 年 ASE/EACVI 关于射血分数保留患者 LV 舒张功能评估的建议。这些建议通常优于之前的 2009 年版本。许多中心还认为 LV(48%)和左心房(53%)的应变评估以及舒张性超声心动图(33%)是评估 LV 舒张功能的有用附加评估。72%的中心经常使用 LV 舒张功能的超声心动图评估来指导治疗。
当前关于 LV 舒张功能评估的建议得到了广泛采用,并且这些建议经常被用来指导患者管理。现在许多中心还认为 LV 和 LA 应变评估对舒张功能的临床评估有用。这些可能会在未来的建议中被考虑。