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

# Diastolic assessment in pulmonary hypertension

Explore the dedicated pulmonary-hypertension diastolic pathway, with its acquisition guidance and method-specific references.

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

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

## Method

2025 ASE Figure 6 · E/A first, then LARS; lateral E/e′ if LARS unavailable

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.

### Mitral E velocity  cm/s

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.

### Mitral e′

PW tissue Doppler at the mitral annulus

- Reduced
- Not reduced
- 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.

### LA reservoir strain

Enter the measured value in the displayed unit

- Available
- Unavailable
- Confirm the variable matches the selected formula.
- Use the unit displayed beside the field.
- Keep measurements from the same representative hemodynamic state.

### LA reservoir strain  %

Enter the measured value in the displayed unit

- Confirm the variable matches the selected formula.
- Use the unit displayed beside the field.
- Keep measurements from the same representative hemodynamic state.

### Lateral 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.

## Sources and method context

American Society of Echocardiography · 2025 · Evaluation of Left Ventricular Diastolic Function and HFpEF Diagnosis · Figure 6 p. 23 · pulmonary-hypertension section pp. 23–24

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

- Pulmonary-hypertension pathway · Figure 6 · PDF p. 23

Mitral E/A and E velocity branches, LARS, and lateral E/e′ fallback thresholds.

- Population limitation · Section 15C · PDF pp. 23–24

Use for filling-pressure estimation in established moderate or severe pulmonary hypertension.

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/)
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- [Left ventricular pressure calculator](https://echosuite.app/guides/lv-pressure/)

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