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Diastolic Function Assessment Algorithm — EECC MCQ

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ModerateCardiac ImagingDiastolic Function Assessment AlgorithmEECC

A 65-year-old man with HFpEF undergoes echocardiographic assessment of diastolic function. The E/A ratio is 1.2, E/e' (average) is 16, LAVi is 38 mL/m², and peak TR velocity is 3.0 m/s. How many criteria for elevated filling pressures are met?

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Correct answer: D — Three of four criteria are met (E/e' >14, LAVi >34, TR velocity >2.8); the 2016 ASE/EACVI diastolic function algorithm requires ≥2 of 4 positive to confirm elevated filling pressures

Explanation lettering: D = shown as A · E = shown as C · A = shown as D · C = shown as E

E/A = 1.2 is in the intermediate range, so E/A alone does not determine diastolic grade; the filling-pressure markers must be assessed. The abnormal thresholds are average E/e′ >14, LAVi >34 mL/m² and peak TR velocity >2.8 m/s. Here, E/e′ = 16, LAVi = 38 mL/m² and TR velocity = 3.0 m/s are all positive. Therefore, three criteria are met, which is sufficient to confirm elevated LV filling pressures; all criteria do not need to be positive.

Reference: British Society of Echocardiography. The assessment of left ventricular diastolic function: guidance and recommendations from the British Society of Echocardiography. Echo Research & Practice, 2024. https://doi.org/10.1186/s44156-024-00051-2