Diastolic function grading & LAP estimation

Algorithm for estimation of mean LAP for patients in sinus rhythm

* Except in MAC, MR, MS, Atrial Fibrillation, LVAD, Non-cardiac PH, HTX, Pericardial constriction

e'

E/e'

Septal e' velocity, cm/s

Septal E/e'

TR V

TR velocity, m/s

Lateral e' velocity, cm/s

Lateral E/e'

PASP, mmHg

Average e' velocity, cm/s

Average E/e'

0

LAVI, mL/m²

Pulmonary vein S/D

LARS, %

IVRT, msec

E/A

Algorithm for estimation of mean LAP for patients with moderate to severe MAC

E/A

IVRT

Algorithm for estimation of mean LAP for patients with Atrial fibrillation

Mitral valve E velocity, cm/s

Septal E/e' ratio

TR velocity, m/s

PASP, mmHg

Deceleration time, ms

LARS, %

BMI, kg/m²

Height

centimeters

inches

Pulmonary vein S/D

Weight

kilograms

pounds

Algorithm for estimation of mean LAP for patients with Pulmonary hypertension

E, cm/s

E/A

e'

e' is reduced

Lateral E/e' ratio

OR

LARS, %

Algorithm for differentiation of pericardial constriction from restrictive cardiomyopathy.

E/A

IVC plethora

Respirophasic septal wall motion

Mitral medial e'

Any or both of these?

Annulus reversus

Diastolic hepatic vein expiratory reversal/forward flow velocity ≥ 0.8

Algorithm for estimation of mean LAP for patients with in heart transplant recipients in sinus rhythm

Septal E/e'

Lateral E/e'

Average E/e'

Mitral E velocity, cm/s

LV strain rate during the isovolumic relaxation period LV strain rate during the isovolumic relaxation period (SRivr), from all 3 apical views

E/SR ivr

OR

TR velocity, m/s

Result

Reference

Nagueh SF, Sanborn DY, Oh JK, Anderson B, Billick K, Derumeaux G, Klein A, Koulogiannis K, Mitchell C, Shah A, Sharma K, Smiseth OA, Tsang TSM. Recommendations for the Evaluation of Left Ventricular Diastolic Function by Echocardiography and for Heart Failure With Preserved Ejection Fraction Diagnosis: An Update From the American Society of Echocardiography. J Am Soc Echocardiogr. 2025 Jul;38(7):537-569. doi: 10.1016/j.echo.2025.03.011. PMID: 40617625.