Diastolic Dysfunction

LV Diastolic Function & LAP Calculator

Based on the 2025 ASE general algorithm for patients in sinus rhythm. LARS is not required.

Important: Do not use the general algorithm in special populations listed below. Missing measurements are never automatically assumed to be normal.

1. Confirm General Algorithm Is Applicable

Patient is in sinus rhythm Severe primary mitral regurgitation Any mitral stenosis Moderate or severe mitral annular calcification Mitral valve repair, replacement, or TEER Non-cardiac pulmonary hypertension LV assist device Heart transplant Pericardial constriction

2. Mitral Inflow

Mitral E velocity (m/s)

Mitral A velocity (m/s)

Mitral E-wave DT (ms)

Displayed for reference only; not used as a stand-alone grading variable.

3. Mitral Annular Tissue Doppler

Septal e′ (cm/s)

Lateral e′ (cm/s)

The calculator automatically derives average e′ and septal, lateral, and average E/e′ when possible.

4. Pulmonary Pressure Variable

Peak TR velocity (m/s)

PASP (mmHg)

If a reliable PASP is entered, it is used preferentially. Otherwise TR velocity is used.

5. Additional Variables

These become especially useful when the three principal variables are discordant.

LAVI (mL/m²)

IVRT (ms)

Pulmonary vein S velocity

Pulmonary vein D velocity

LVEF (%)

6. Clinical Context

Patient has unexplained dyspnea / symptoms concerning for HFpEF

Enter measurements above.

ASE thresholds used by this calculator

Variable	Threshold
Septal e′	≤ 6 cm/s = reduced
Lateral e′	≤ 7 cm/s = reduced
Average e′	≤ 6.5 cm/s = reduced
Septal E/e′	≥ 15 = increased
Lateral E/e′	≥ 13 = increased
Average E/e′	≥ 14 = increased
TR velocity	≥ 2.8 m/s = increased
PASP	≥ 35 mmHg = increased
LAVI	> 34 mL/m² = abnormal
Pulmonary vein S/D	≤ 0.67 supports elevated LAP
IVRT	≤ 70 ms supports elevated LAP

Clinical decision-support tool only. Measurements must first be technically valid and interpreted in the full clinical and echocardiographic context.