Canonical: https://echosuite.app/guides/diastolic-exercise/

# Diastolic exercise echocardiography assessment

Find the exercise-echo diastolic pathway, its measurement inputs and the source context provided by the interactive tool.

Created by [Mohammed Kamareddine, MD](https://echosuite.app/about/) · [Sources & educational scope](https://echosuite.app/about/)

[Open interactive calculator →](https://echosuite.app/calculators/#diastolic-exercise)

## Method

2025 ASE Section 13 · selected exercise E/e′ method plus exercise TR velocity

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

### Exercise E/e′ method

PW tissue Doppler at the mitral annulus

- Average E/e′
- Septal E/e′
- 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.

### Exercise 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.

### Exercise septal 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.

### Exercise TR 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.

## Sources and method context

American Society of Echocardiography · 2025 · Evaluation of Left Ventricular Diastolic Function and HFpEF Diagnosis · Section 13 · PDF pp. 18–19

[Primary reference](https://www.asecho.org/wp-content/uploads/2025/07/Left-Ventricular-Diastolic-Function.pdf)

- Indication and acquisition · Section 13A–B · PDF p. 18

Appropriate patient selection, exercise modalities, acquisition order, and postexercise timing.

- Normal, likely, and abnormal branches · Section 13C · PDF p. 19

E/e′ and exercise TR-velocity thresholds, including the guideline's likely-HFpEF branch.

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.

## Keep exploring

- [Apical four chamber acquisition guide](https://echosuite.app/guides/views/apical-four-chamber/) · [Open in Probe Lab](https://echosuite.app/#a4c)
- [Left atrial pressure calculator: E/e′ method](https://echosuite.app/guides/lap-ee/)
- [Left atrial pressure calculator: mitral regurgitation velocity](https://echosuite.app/guides/lap-mr/)
- [Left atrial volume index calculator: LAVI](https://echosuite.app/guides/la-size/)
- [Left ventricular pressure calculator](https://echosuite.app/guides/lv-pressure/)

[All echo guides](https://echosuite.app/guides/) · [Learning paths](https://echosuite.app/learn/)