BACKGROUND Evaluation of diastolic dysfunction is crucial in determining elevated left atrial pressure. However, a validation of the long-term prognostic value of the newly proposed algorithm updated in 2016 has not been performed. The aim of the present study was to investigate the relative value of the updated 2016 diastolic dysfunction grading system for the incidence of readmission in patients with heart failure (HF) with reduced ejection fraction (HFrEF) and HF with preserved ejection fraction (HFpEF). METHODS Two hundred thirty-two patients hospitalized with HF were retrospectively evaluated. Subjects were divided into two subgroups: those with HFrEF (n = 127) and those with HFpEF (n = 105). Readmission risk scores were calculated using the Yale Center for Outcomes Research and Evaluation HF, LACE index, and HOSPITAL scores. The primary end point was readmission following HF and cardiac death. RESULTS Over a period of 24 months, 86 patients were either readmitted or died. Multivariate Cox analysis was performed on both the HFrEF and HFpEF groups. In the HFrEF group, both the 2009 and 2016 algorithms had superior incremental value for the association of the primary end point to several readmission risk scores. In the HFpEF group, only the 2016 algorithm led to significant improvement in association with the primary end point. The 2016 algorithm had incremental value over several readmission risk scores alone. CONCLUSIONS The recommendations of the 2016 algorithm can be useful for readmission and cardiac mortality risk assessment in patients with HFrEF and HFpEF. The use of echocardiography to estimate elevated left atrial pressure appears to identify a higher risk group and may allow a more tailored approach to therapy.

中文翻译：

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心力衰竭住院患者的最新左心室舒张功能建议和心血管事件。

背景技术舒张功能障碍的评估对于确定升高的左心房压力至关重要。但是，尚未对2016年更新的新算法的长期预后价值进行验证。本研究的目的是研究更新的2016年舒张功能障碍分级系统对射血分数降低（HFrEF）的心力衰竭（HF）和射血分数保留（HFpEF）的HF再入院率的相对价值。方法回顾性分析232例HF患者。受试者分为两个亚组：HFrEF组（n = 127）和HFpEF组（n = 105）。使用耶鲁大学结局研究和评估中心HF，LACE指数和医院分数来计算再入院风险分数。主要终点是心力衰竭和心源性死亡后再次入院。结果在24个月的时间里，有86名患者重新入院或死亡。对HFrEF和HFpEF组均进行了多变量Cox分析。在HFrEF组中，2009年和2016年算法对于主要终点与多个再入院风险评分的关联均具有更高的增量值。在HFpEF组中，只有2016年算法导致与主要终点相关的显着改善。2016年算法仅在几个再入院风险评分上就具有增量价值。结论2016年算法的建议可用于HFrEF和HFpEF患者的再入院和心脏死亡风险评估。