Sorrentino R, Esposito R, Santoro C, et al. - A total of 1,508 outpatients who were referred to an echocardiography laboratory during a predefined 5-month period were prospectively recruited in order to evaluate the concordance between the 2016 and 2009 recommendations and to examine the influence of the acknowledgment of “myocardial disease” suggested in the 2016 update on the assessment of diastolic dysfunction (DD) and LV filling pressures in individuals with normal and decreased LV ejection fractions referred to a general echocardiography laboratory. Between the two recommendations, overall proportion of agreement was 64.7%. On contrasting the 2009 and 2016 recommendations, 47.5% and 36.1%, and 22.7% and 12.6% of individuals had DD and raised LV filling pressures, respectively. In the setting of individuals with normal LV ejection fractions, this distinction continued to be important. In the prosecution of the 2016 recommendations, whether or not the presence of “myocardial disease” was acknowledged, the prevalence of undetermined diastolic function was, 7.3% vs 13.7%, respectively, whereas individuals in whom the DD grade could not be ascertained, they were 8.1% vs 14.4%. Hence, when prosecuting the 2016 recommendations, acknowledging the presence of myocardial disease led to a lower incidence of inconclusive diagnosis.