Diastolic function assessment: sinus rhythm
Start with the measurements available and explore EchoSuite’s general sinus-rhythm diastolic pathway. The interactive tool keeps incomplete measurements visible and asks the next relevant question.
Method
2025 ASE Figure 3 · relaxation → LAP markers → supplemental markers → grade
Use the measurement units shown below. Some fields apply only to a selected method or condition; follow the interactive tool’s method choices. The interactive tool keeps missing measurements incomplete and provides its method-specific results and reference context.
Measurements and acquisition
Mitral E/A ratio
PW Doppler at the mitral leaflet tips
- Place the PW sample between the mitral leaflet tips.
- Record at end-expiration with a clear E and A wave.
- Measure the requested peaks or trace the requested envelope.
Septal e′ cm/s
PW tissue Doppler at the mitral annulus
- Place the sample at the septal or lateral mitral annulus.
- Use tissue-Doppler settings and align with annular motion.
- Measure the early diastolic e′ peak and average representative beats.
Lateral e′ cm/s
PW tissue Doppler at the mitral annulus
- Place the sample at the septal or lateral mitral annulus.
- Use tissue-Doppler settings and align with annular motion.
- Measure the early diastolic e′ peak and average representative beats.
Average E/e′
PW tissue Doppler at the mitral annulus
- Place the sample at the septal or lateral mitral annulus.
- Use tissue-Doppler settings and align with annular motion.
- Measure the early diastolic e′ peak and average representative beats.
TR peak velocity m/s
CW Doppler through the TR jet
- Search RV inflow, apical four-chamber, and subcostal windows; use the highest well-aligned signal.
- Trace the dense primary edge (‘chin’), not faint overgained noise, and reject truncated triangular envelopes when estimating pressure.
- Average three representative beats; in atrial fibrillation average 5–10 beats and exclude post-pause or post-ectopic velocities.
PASP mmHg
Contemporaneous cuff or invasive value
- Use a pressure obtained in the same hemodynamic state as the echo.
- Confirm the value is entered in mmHg.
- Do not mix values acquired under different loading conditions.
LA reservoir strain %
Enter the measured value in the displayed unit · Optional
- Confirm the variable matches the selected formula.
- Use the unit displayed beside the field.
- Keep measurements from the same representative hemodynamic state.
Pulmonary vein S/D
Pulsed-wave Doppler · Optional
- Place the sample volume at the specified annulus or outflow tract.
- Align the Doppler beam with flow and record a clean envelope.
- Trace the modal velocity envelope and use the reported VTI.
LA volume index mL/m²
Enter the measured value in the displayed unit · Optional
- Confirm the variable matches the selected formula.
- Use the unit displayed beside the field.
- Keep measurements from the same representative hemodynamic state.
IVRT ms
Spectral Doppler timing · Optional
- Use a sweep speed that clearly shows the interval boundaries.
- Measure from the specified onset to offset.
- Average representative beats using consistent rhythm handling.
Sources and method context
American Society of Echocardiography · 2025 · Evaluation of Left Ventricular Diastolic Function and HFpEF Diagnosis · Clinical scope p. 2 · Table 6 p. 16 · Figure 3 p. 17
- Primary and supplemental pathway · Figure 3 · PDF p. 17
Reduced e′, E/e′, TR velocity or PASP, supplemental markers, LAP assignment, and grades 1–3.
- Age-adjusted relaxation · Table 6 · PDF p. 16
Age-adjusted lower limits for septal, lateral, and average mitral annular e′.
- Applicability and exclusions · Clinical considerations p. 2 · Figure 3 caption p. 17
Adult ambulatory or acute-care scope; exclusions for special populations and mitral interventions.
Catalogue review status: Exact guideline locator mapped · clinical sign-off pending
These pages describe the educational tool. Interpret measurements with the complete clinical context and the method’s acquisition limitations.