A unified echocardiography reference for assessing left ventricular diastolic function and filling pressures across common clinical conditions. Select a clinical context to view its criteria, tables, and reference illustrations.
Reference section 01
Assessment of LV diastolic function and filling pressure reference.
LAP indeterminate if only 1 of 3 parameters available. Pulmonary vein S/D ratio <1 applicable to conclude elevated LAP in patients with depressed LV EF.
Recommendations for the Evaluation of LV Diastolic Function by Echocardiography: An Update from the ASE and EACVI (2016)
Reference section 02
Assessment of LV filling pressures in atrial fibrillation.
Echocardiographic parameters and reference thresholds
| Peak acceleration rate of mitral E velocity (>1,900 cm/sec 2) |
| IVRT (<65 msec) |
| DT of pulmonary venous diastolic velocity (<220 msec) |
| E/Vp ratio (>1.4) |
| Septal E/e' ratio (>11) |
Reference section 03
Assessment criteria when mitral E and A velocities may fuse.
Echo Value · Diastolic Function
Reference criteria for assessment when sinus tachycardia causes partial or complete fusion of mitral E and A velocities.
| Mitral inflow pattern with predominant early LV filling in patients with EFs <50% |
| IVRT <70 msec is specific (79%) |
| Pulmonary vein systolic filling fraction <40% is specific (88%) |
| Average E/e' >14 (this cutoff has highest specificity but low sensitivity) |
| When E and A velocities are partially or completely fused, the presence of a compensatory period after premature beats often leads to separation of E and A velocities which can be used for assessment of diastolic function |
Reference section 04
Reference for heart transplant, atrioventricular block, paced rhythm, and atrial fibrillation with impaired EF.
Diastolic function reference
Reference section 05
Assessment of LV filling pressures in hypertrophic cardiomyopathy.
Echocardiography reference
Reference parameters for echocardiographic assessment of left ventricular filling pressures.
| Average E/e' (>14) |
| Ar-A (>30 msec) |
| TR peak velocity (>2.8 m/sec) |
| LA volume (>34 mL/m2) |
Recommendations for Cardiac Chamber Quantification by Echocardiography in Adults: An Update from the ASE and EACVI (2015)
Guideline reference
Recommendations for the Evaluation of LV Diastolic Function by Echocardiography: An Update from the ASE and EACVI (2016)
ASE recommendations for the evaluation of LV diastolic function by echocardiography: Quick reference (2016)
Reference section 06
Assessment of LV filling pressures in mitral regurgitation.
| Ar-A (>30 msec) |
| IVRT (<60 msec has high specificity) |
| IVRT/TE-e' (<5.6) may be applied for the prediction of LV filling pressures in patients with MR and normal EFs |
| Average E/e' (>14) may be considered only in patients with depressed EFs |
Recommendations for Cardiac Chamber Quantification by Echocardiography in Adults: An Update from the ASE and EACVI (2015)
Recommendations for the Evaluation of LV Diastolic Function by Echocardiography: An Update from the ASE and EACVI (2016)
ASE recommendations for the evaluation of LV diastolic function by echocardiography: Quick reference (2016)
Reference section 07
Assessment of LV filling pressures in mitral stenosis.
| IVRT (<60 msec has high specificity) |
| IVRT/TE-e' (<4.2) |
| Mitral A velocity (>1.5 m/sec) |
Recommendations for Cardiac Chamber Quantification by Echocardiography in Adults: An Update from the ASE and EACVI (2015)
Recommendations for the Evaluation of LV Diastolic Function by Echocardiography: An Update from the ASE and EACVI (2016)
ASE recommendations for the evaluation of LV diastolic function by echocardiography: Quick reference (2016)
Reference section 08
Assessment of LV filling pressures in noncardiac pulmonary hypertension.
Echocardiographic parameter for distinguishing cardiac from noncardiac causes of increased pulmonary artery pressures.
| Lateral E/e' can be applied to determine whether a cardiac etiology is the underlying reason for the increased pulmonary artery pressures |
| When cardiac etiology is present, lateral E/e' is >13, whereas in patients with pulmonary hypertension due to a noncardiac etiology, lateral E/e' is <8 |
Recommendations for Cardiac Chamber Quantification by Echocardiography in Adults: An Update from the ASE and EACVI (2015)
Reference section 09
Assessment of LV filling pressures in restrictive cardiomyopathy.
Echocardiographic parameters
| DT (<140 msec) |
| Mitral E/A (>2.5) |
| IVRT (<50 msec has high specificity) |
| Average E/e' (>14) |
Recommendations for Cardiac Chamber Quantification by Echocardiography in Adults: An Update from the ASE and EACVI (2015)
