BACKGROUND Classification of left ventricular diastolic function (LVDF) by echocardiography is controversial. The aim of this study was to evaluate the impact of the last 2016 recommendations for LVDF evaluation on brain natriuretic peptide (BNP) levels, proportion of final heart failure (HF) diagnosis, and cardiovascular outcomes. METHODS Outpatients with first consultation at a one-stop HF clinic (2009-2014) were screened. The initial visit included echocardiography with LVDF evaluation and determination of BNP level. HF diagnosis was confirmed or ruled out at the end of the visit. Cardiovascular events during follow-up were recorded. LVDF classification was originally performed with the 2009 recommendations and reevaluated using the 2016 recommendations. RESULTS A total of 157 patients (mean age 73.24 ± 10.3 years; 70.1% women) were included. Originally (2009 recommendations), most of the patients were classified with grade I diastolic dysfunction (DD; 67.5%). After the reanalysis using the 2016 recommendations, 49% were reclassified with normal LVDF. These subjects showed lower BNP levels (40.8 pg/mL) and a lower proportion of HF diagnosis (9.6%). Another part of the initial grade I DD group (31.1%) was reclassified with indeterminate LVDF; they had intermediate BNP levels, proportion of HF, and rate of cardiovascular events. Lower reclassification rates were observed in the other groups of DD. Kaplan-Meier survival curves showed significantly better prognostic stratification after the reclassification (P = .539 vs P = .003). CONCLUSIONS Current recommendations for the evaluation of LVDF by echocardiography resulted in more accurate classification of patients, according to their BNP levels, HF diagnosis, and cardiovascular outcomes, especially for those patients previously classified with grade I DD.

中文翻译：

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当前建议通过超声心动图评估左心室舒张功能的不同临床意义。

背景技术超声心动图对左心室舒张功能（LVDF）的分类是有争议的。这项研究的目的是评估LVDF评估的最新2016年建议对脑钠肽（BNP）水平，最终心力衰竭（HF）诊断比例和心血管结局的影响。方法对一站式HF诊所（2009- 2014年）进行初诊的患者进行筛查。最初的访视包括超声心动图，LVDF评估和BNP水平的测定。访视结束时证实或排除了心力衰竭的诊断。记录随访期间的心血管事件。LVDF分类最初是根据2009年的建议进行的，然后使用2016年的建议进行了重新评估。结果共纳入157例患者（平均年龄73.24±10.3岁；女性70.1％）。最初（2009年推荐），大多数患者被归为I级舒张功能障碍（DD； 67.5％）。使用2016年建议进行重新分析后，有49％的患者被重新分类为正常LVDF。这些受试者表现出较低的BNP水平（40.8 pg / mL）和较低的HF诊断比例（9.6％）。最初的I DD组的另一部分（31.1％）被重新分类为不确定的LVDF。他们具有中等的BNP水平，HF比例和心血管事件发生率。在DD的其他组中观察到较低的重分类率。重新分类后，Kaplan-Meier生存曲线显示出更好的预后分层（P = .539 vs P = .003）。结论当前有关通过超声心动图评估LVDF的建议可对患者进行更准确的分类，