Diastology, Simplified

When most people think about cardiac function, they think about systole. But diastolic function—the heart’s ability to relax and fill—is equally critical and one of the most complex areas of transthoracic echocardiography (TTE).

In July 2025, the American Society of Echocardiography released updated diastology guidelines, prompting renewed debate and confusion around grading diastolic dysfunction. This lesson simplifies the process with a step-by-step, case-based approach you can apply during real-world exams.

You’ll learn:

• What diastolic dysfunction is and how it presents on echocardiography

• How to grade diastolic function using a simplified flowchart

• The 3 key questions (e′ velocity, E/e′, TR velocity/PASP) every cardiac sonographer should assess

• How to apply the algorithm through a full case walkthrough

By integrating tissue Doppler, transmitral inflow, and supportive parameters, this lesson shows how to move beyond single measurements and confidently estimate filling pressures and diastolic grade.