Introduction
Heart failure (HF) remains a rising global epidemic, with an estimated
prevalence of > 37.7 million individuals globally (1, 2).
Excluding sub-Saharan Africa, the rates of death from noncommunicable
diseases, such as HF, are increasing worldwide (3). Left ventricular
(LV) diastolic dysfunction (DD) is a recognized pathophysiologic
mechanism of heart failure (4-6). Moreover, even in the absence of heart
failure, DD has been shown to have independent prognostic significance
(7, 8). While the gold standard for assessing diastolic dysfunction is
thought to be derived from ventricular pressure volume relationships,
this invasive approach is rarely used in clinical practice.
Echocardiography allows indirect non-invasive evaluation of LV diastolic
function (9-11). However, applicability of echocardiography for
evaluations of LV filling and relaxation parameters in a clinical
setting may be significantly limited if measurements of diastolic
parameters are exceedingly time-consuming or affected by reduced
feasibility and excessive variability. Therefore, evaluation of the
time-consumption, as well as the feasibility and reproducibility, in a
realistic clinical setting is important.
The majority of validations studies is reporting re-analyse
reproducibility, only few report re-test reproducibility (12, 13).
Recently, updated recommendations for the classification of diastolic
function has been released (9). Indeed, this algorithm is based on
expert consensus and on parameters in which the re-test reproducibility
is unknown, stressing the need to validate it in a clinical setting.
Presently, the available literature regarding the feasibility and
re-test reproducibility of the latest recommended diastolic measurements
and their impact on the guideline’s classification algorithms are
scarce.
The aim of this study was to evaluate the feasibility, time consumption,
and the intra- and inter-observer re-test reproducibility of
echocardiographic indexes and classification algorithms of diastolic
function.