Clinical Report: Changes in Diastolic Function Grading Under 2025 ASE Criteria
Overview
A significant proportion of echocardiograms (20.1%) were assigned different diastolic function grades when evaluated using the 2025 ASE guidelines compared to the 2016 guidelines.
Background
Diastolic dysfunction is prevalent in heart failure patients and is associated with considerable morbidity and mortality. Accurate grading of diastolic function is crucial.
Data Highlights
| Criteria | 2016 Guidelines | 2025 Guidelines |
|---|---|---|
| Normal Diastolic Function | 78.9% | 73.8% |
| Grade 1 Diastolic Dysfunction | 11.9% | 15.7% |
| Grade 2 Diastolic Dysfunction | 6.4% | 8.4% |
| Grade 3 Diastolic Dysfunction | 2.7% | 2.0% |
Key Findings
- 20.1% of echocardiograms received different diastolic function grades under the 2025 guidelines.
- 14.0% of studies were upgraded in diastolic dysfunction classification with the new guidelines.
- 6.1% of studies were downgraded in diastolic dysfunction classification with the new guidelines.
- The proportion of studies classified as having normal diastolic function decreased from 78.9% to 73.8% under the 2025 guidelines.
- Older age, female sex, and higher left ventricular systolic function were associated with increased diastolic dysfunction grading using the 2025 guidelines.
Clinical Implications
Clinicians should be aware of these changes when interpreting echocardiographic results.
Conclusion
The transition to the 2025 ASE diastolic function criteria results in notable reclassification of diastolic dysfunction.
Related Resources & Content
- American Society of Echocardiography, Journal of the American Society of Echocardiography, 2025 -- What Changes Under 2025 ASE Diastolic Function Criteria?
- European Radiology, Validation of 4D Flow MRI for Assessing Grading of Left Ventricular Diastolic Dysfunction Compared to Echocardiography, 2025
- Clinical Research in Cardiology, Diastolic Dysfunction in Patients With and Without Heart Failure Preserved Ejection Fraction, 2021
- Clinical Research in Cardiology, Evaluation of Atrial Conduit Function: Introducing a Novel Index for Diastolic Dysfunction Assessment, 2015
- Echocardiographic Diastolic Function Grading in HFpEF: Testing the Updated 2025 ASE Criteria | JACC, 2025
- Clinical Research in Cardiology — Evaluation of Left Ventricular Diastolic Function in Pediatric Patients Following Successful Aortic Coarctation Repair
- Recommendations for the Evaluation of Left Ventricular Diastolic Function by Echocardiography and for Heart Failure With Preserved Ejection Fraction Diagnosis: An Update From the American Society of Echocardiography
- Echocardiographic Diastolic Function Grading in HFpEF: Testing the Updated 2025 ASE Criteria | JACC
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