Recommendations for the Evaluation of Left Ventricular Diastolic Function by Echocardiography and for Heart Failure With Preserved Ejection Fraction Diagnosis: An Update From the American Society of Echocardiography

Echocardiographic assessment of left ventricular (LV) diastolic function is an integral part of the routine evaluation of patients presenting with symptoms of dyspnea or clinical concerns for heart failure. Given the presence of diastolic dysfunction in many cardiovascular diseases, clinical reports should include comments on diastolic function and/or left atrial (LA) pressure whenever possible. Since the publication of the 2016 ASE/EACVI guidelines for assessment of LV diastolic function, new data on additional echocardiographic variables as left atrial strain and their association with LV filling pressures have emerged. Moreover, prognostic data from epidemiologic studies have demonstrated the association of echocardiographic measures with the subsequent development of heart failure. This update provides a contemporary approach for the assessment of LV diastolic function and the estimation of LA pressure in the general population of patients in sinus rhythm referred for echocardiographic evaluation, and in special populations that require deviation from the general approach. The update also discusses the application of echocardiography in the diagnosis of patients with heart failure with preserved LV ejection fraction.