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

# Diastolic assessment in mitral annular calcification

Find the dedicated diastolic assessment pathway for moderate or severe mitral annular calcification (MAC), with its own inputs and method context.

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

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

## Method

2025 ASE Figure 4 · E/A <0.8 normal; >1.8 elevated; 0.8–1.8 uses IVRT

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

### Mitral E/A ratio

PW Doppler at the mitral leaflet tips

- Place the PW sample between the mitral leaflet tips.
- Record at end-expiration with a clear E and A wave.
- Measure the requested peaks or trace the requested envelope.

### IVRT  ms

Spectral Doppler timing

- Use a sweep speed that clearly shows the interval boundaries.
- Measure from the specified onset to offset.
- Average representative beats using consistent rhythm handling.

## Sources and method context

American Society of Echocardiography · 2025 · Evaluation of Left Ventricular Diastolic Function and HFpEF Diagnosis · Table 7 p. 20 · Figure 4 p. 22

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

- MAC pathway · Figure 4 · PDF p. 22

E/A outer branches and IVRT resolution of the intermediate E/A range.

- MAC thresholds · Table 7 · PDF p. 20

E/A and IVRT thresholds for moderate or severe mitral annular calcification.

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.

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