Diastolic function
Grades LV diastolic function and estimates LA pressure from mitral inflow, tissue Doppler, TR velocity and LA volume.
ASE/EACVI 2016 recommendations
How it's calculated
Normal LVEF without myocardial disease
Four variables are checked. Diastolic dysfunction is present when more than half of the available ones are abnormal, normal when fewer than half are, and indeterminate at exactly half.
Average E/e′ > 14 Septal e′ < 7 cm/s or lateral e′ < 10 cm/s TR velocity > 2.8 m/s LA volume index > 34 mL/m²When dysfunction is found, it is graded with the second algorithm.
Reduced LVEF, or myocardial disease
- E/A ≤ 0.8 with E ≤ 50 cm/s: normal LA pressure, grade I.
- E/A ≥ 2: elevated LA pressure, grade III.
- Anything in between: check E/e′ > 14, TR > 2.8 m/s and LAVI > 34 mL/m². With all three available, two or more positive means elevated pressure (grade II) and two or more negative means normal pressure (grade I). With only two available, both must agree; if they split, the grade is indeterminate.
The algorithm does not apply in atrial fibrillation, significant mitral valve disease, mitral annular calcification, LVADs, or heart transplant. Nagueh SF, et al. J Am Soc Echocardiogr 2016;29:277–314.
For education and as a reporting aid. A result supports the reading of the full study and does not replace it.