In a retrospective, single-center cohort, 20.1% of echocardiograms that met criteria for analysis were assigned different diastolic function grades when evaluated using the 2016 and 2025 American Society of Echocardiography guidelines.
The study evaluated 300,828 adult transthoracic echocardiograms performed between 2013 and 2022. Researchers applied both the 2016 and 2025 American Society of Echocardiography diastolic function grading algorithms to each study. Echocardiograms were excluded if diastolic function was indeterminate or could not be assessed using either guideline.
A total of 87,724 studies met criteria for analysis. Researchers created a multiple logistic regression model based on demographic and clinical characteristics to predict upgraded diastolic dysfunction using the 2025 guidelines.
Overall, 17,639 studies, or 20.1%, received a different diastolic function grade when the 2025 guidelines were applied. According to the investigators, 12,246 studies (14.0%) were upgraded, 5,393 studies (6.1%) were downgraded, and 70,085 studies were unchanged.
The proportion of studies classified as having normal diastolic function was lower under the 2025 guidelines than under the 2016 guidelines, at 73.8% vs 78.9%. Grade 1 diastolic dysfunction accounted for 15.7% of studies under the 2025 criteria compared with 11.9% under the 2016 criteria. Grade 2 diastolic dysfunction accounted for 8.4% of studies under the 2025 criteria compared with 6.4% under the earlier guidelines. Grade 3 diastolic dysfunction accounted for 2.0% of studies under the 2025 criteria compared with 2.7% under the 2016 criteria.
In a multiple logistic regression model, older age, female sex, and higher left ventricular systolic function were associated with increased diastolic dysfunction grading using the 2025 guidelines.
The researchers concluded that more studies were classified as having diastolic dysfunction under the 2025 guidelines than under the 2016 guidelines.
Disclosures were not reported in the supplied abstract text.
