What Changes Under 2025 ASE Diastolic Function Criteria?

Researchers evaluated 300,828 adult transthoracic echocardiograms using the 2016 and 2025 American Society of Echocardiography diastolic function guidelines; 87,724 met criteria for analysis.

By
Kathryn Wighton
June 26, 2026
3 min

MDSpire News

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.