umu.sePublications
Change search
ReferencesLink to record
Permanent link

Direct link
Effect of Echocardiographic Grading of Left Ventricular Diastolic Dysfunction by Different Classifications in Primary Care
Show others and affiliations
2015 (English)In: American Journal of Cardiology, ISSN 0002-9149, E-ISSN 1879-1913, Vol. 116, no 7, 1144-1152 p.Article in journal (Refereed) Published
Abstract [en]

The presence of left ventricular (LV) diastolic dysfunction (DD) as characterized by Doppler echocardiography is associated with worse overall mortality both in symptomatic and asymptomatic patients. However, available data on this topic come from referral centers and have been obtained by different, validated algorithms for each single study. Thus, we aimed at determining the feasibility of comprehensive evaluation of LVDD in a primary care outpatient setting and at testing the concordance of different methodological approaches in grading diastolic dysfunction. Eight hundred eighty-five consecutive outpatients, in sinus rhythm, prospectively underwent Doppler echocardiography according to a predetermined protocol. Feasibility of each LV diastolic index and concordance between 3 methods to determine the degree of LVDD, namely the American Society of Echocardiography/European Association of Echocardiography (ASE/EAE) reconunendations, the Olmstead County, and the Canberra Study protocols, were tested. Feasibility of all diastolic indexes was high, ranging from 93% of Valsalva maneuver to 99% for mitral inflow and tissue Doppler parameters. Diastolic function was not classifiable in 6% to 19% of patients. The concordance for LV diastolic dysfunction degree was fair when comparing the classification of the ASE/EAE with those from Olinstead County (kappa = 0.25; reclassification rate 51%) and Canberra Study (kappa = 0.27; reclassffication rate 43.7%), and was good for the comparison betvveen the Olmstead County and Canberra classifications (kappa = 0.68, reclassification rate 27%). In conclusion, feasibility of LV diastolic function measurements is very high and grading diastolic dysfunction is possible in most patients in primary care settings. Substantial differences, however, exist when concordance is tested among 3 documented criteria, resulting in poor concordance of data interpretation and hence patient stratification and clinical management. 

Place, publisher, year, edition, pages
2015. Vol. 116, no 7, 1144-1152 p.
National Category
Cardiac and Cardiovascular Systems
Identifiers
URN: urn:nbn:se:umu:diva-111004DOI: 10.1016/j.amjcard.2015.07.010ISI: 000362382400026PubMedID: 26256581OAI: oai:DiVA.org:umu-111004DiVA: diva2:868635
Available from: 2015-11-11 Created: 2015-11-02 Last updated: 2015-12-04Bibliographically approved

Open Access in DiVA

No full text

Other links

Publisher's full textPubMed

Search in DiVA

By author/editor
Henein, Michael Y.
By organisation
Cardiology
In the same journal
American Journal of Cardiology
Cardiac and Cardiovascular Systems

Search outside of DiVA

GoogleGoogle Scholar
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

Altmetric score

Total: 36 hits
ReferencesLink to record
Permanent link

Direct link