Application of the 2016 ASE-EACVI Criteria for the Assessment of Diastolic Function in Arterial Hypertension

High Blood Press Cardiovasc Prev. 2024 Jul;31(4):405-410. doi: 10.1007/s40292-024-00655-z. Epub 2024 Jun 15.

Abstract

Introduction: No data are available on the diagnostic algorithms recommended by guidelines for the assessment of diastolic dysfunction (DD) in patients with arterial hypertension.

Aim: To fill this gap, we evaluated diastolic function in hypertensive patients with and without LVH matched with healthy subjects by applying 2016 American Society of Echocardiography-European Association of Cardiovascular Imaging Guidelines for the evaluation of LV diastolic function.

Methods: 717 healthy and hypertensives with normal LV ejection fraction and with and without LV hypertrophy (LVH), matched 1:1:1 from two prospective registries, represented the study population.

Results: By applying algorithm A, indeterminate pattern was found in 0.4% of healthy, in 6.3% of hypertensives without LVH, and in 21% with LVH (overall p < 0.05 vs. healthy). DD was absent in healthy, however present in 2 and 8% of hypertensives without and with LVH (p = 0.06 and p = 0.001 vs. healthy, respectively). By applying algorithm B, no cases of indeterminate pattern were found. DD was observed in 2.9% of healthy, 7 and 10.5% of hypertensives without and with LVH (p < 0.05 vs. healthy).

Conclusions: The use of algorithm A should be limited only to truly normal subjects, whereas algorithm B should be applied to all patients with hypertension, even without comorbidities and irrespective of LVH.

Keywords: Guidelines; Arterial Hypertension; Diastolic function.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Algorithms*
  • Arterial Pressure
  • Case-Control Studies
  • Diastole*
  • Female
  • Humans
  • Hypertension* / diagnosis
  • Hypertension* / physiopathology
  • Hypertrophy, Left Ventricular* / diagnosis
  • Hypertrophy, Left Ventricular* / diagnostic imaging
  • Hypertrophy, Left Ventricular* / physiopathology
  • Male
  • Middle Aged
  • Practice Guidelines as Topic
  • Predictive Value of Tests*
  • Prospective Studies
  • Registries*
  • Reproducibility of Results
  • Stroke Volume
  • Ventricular Dysfunction, Left / diagnostic imaging
  • Ventricular Dysfunction, Left / physiopathology
  • Ventricular Function, Left*