Frequently Asked Questions

LVEF by Simpson biplane is calculated from end-diastolic and end-systolic volumes: LVEF = (EDV − ESV) / EDV × 100%. Normal LVEF is ≥ 52% (men) or ≥ 54% (women) per ASE.

Severe aortic stenosis per ESC 2025 is defined by: Vmax ≥ 4 m/s, mean gradient ≥ 40 mmHg, and/or AVA ≤ 1.0 cm² (indexed ≤ 0.6 cm²/m²). All three criteria should be assessed together.

Diastolic Dysfunction (ASE 2025): EF-independent. The algorithm is based on e′, E/e′, and TR velocity/PASP. Goal: estimation of left atrial pressure (LAP) followed by grading. Grade 1: Normal LAP (typically only e′ reduced), usually E/A ≤ 0.8. Grade 2 (pseudonormal): Elevated LAP + E/A < 2. Grade 3 (restrictive): Elevated LAP + E/A ≥ 2.

TAPSE is measured in the apical 4-chamber view (RV-focused) using M-mode. The cursor is placed at the lateral tricuspid annulus, and the maximal systolic excursion is measured. At least three cardiac cycles should be averaged.

The TAPSE/PASP ratio reflects right ventricular–pulmonary arterial (RV–PA) coupling. Values between 0.3 and 0.4 mm/mmHg indicate impaired RV–PA coupling and represent an important prognostic parameter in pulmonary hypertension.

The normal left ventricular mass index (LVMI) is ≤95 g/m² in women and ≤115 g/m² in men (M-mode method) according to ASE guidelines. Higher values indicate left ventricular hypertrophy. In addition, relative wall thickness (RWT) is used for morphological classification into concentric or eccentric hypertrophy.

An LA volume index > 34 ml/m² is considered elevated (ASE). This is an important marker for chronically elevated LV filling pressures and is associated with increased atrial fibrillation risk.

Mitral stenosis is classified based on mitral valve area (MVA – planimetry in the short-axis view), pressure half-time (PHT), mean pressure gradient, and estimated systolic pulmonary artery pressure (sPAP): Mild: MVA > 2.5 cm² / PHT < 100 ms / mean gradient < 5 mmHg / sPAP < 30 mmHg. Moderate: MVA 1.6–2.5 cm² / PHT 100–149 ms / mean gradient 5–9 mmHg / sPAP 30–49 mmHg. Severe: MVA < 1.5 cm² / PHT > 150 ms / mean gradient ≥ 10 mmHg / sPAP ≥ 50 mmHg.

Mitral Regurgitation – Severity (ASE 2017, concise): In general, a transmitral E/A ratio (PW Doppler) < 1 argues against severe mitral regurgitation. The same usually applies if regurgitation is present only during part of systole (non-holosystolic MR). If these features are absent, MR severity should be assessed using an integrative approach, preferably considering the following six pathological criteria: Flail leaflet, Dilated left ventricle with preserved EF, MR jet occupying >50% of the left atrium (applies to central jets), Vena contracta > 7 mm, PISA radius > 10 mm (aliasing velocity 30–40 cm/s), Systolic flow reversal in at least 2 pulmonary veins. Severe mitral regurgitation is present if: ≥4 criteria are fulfilled; ≥3 criteria plus an EROA (by PISA) ≥ 0.3 cm² or a regurgitant volume ≥ 45 mL (PISA or quantitative method); ≥2 criteria plus an EROA ≥ 0.4 cm² or a regurgitant volume ≥ 60 mL.

TTE (transthoracic echocardiography) is the non-invasive standard examination through the chest wall. TEE (transesophageal echocardiography) uses a swallowed probe and provides higher image quality — especially valuable for atrial thrombi, prosthetic valves, and infective endocarditis.

Reference values are updated in accordance with publications from the ASE (American Society of Echocardiography) and EACVI (European Association of Cardiovascular Imaging). The calculators are currently based on the most recent ASE and EACVI guidelines.

Yes, many calculators use sex-specific reference values. The 2D echocardiography calculator differentiates by sex for LVEF, LVEDD, LVMI, wall thickness, and aortic dimensions in accordance with ASE guidelines.

All calculators are based on evidence-based guidelines from the ASE (American Society of Echocardiography), EACVI (European Association of Cardiovascular Imaging), and DEGUM. Detailed references, including DOIs, are provided on each calculator page.

Speckle-tracking echocardiography tracks acoustic markers within the ultrasound image to analyze myocardial deformation. Global longitudinal strain (GLS) represents the average longitudinal strain of all LV segments. Normal: GLS < −18% (typically around −19% or more negative). Borderline: −16% to −18%. GLS can detect subclinical myocardial dysfunction even when LVEF is still normal.

EchoMastery Pro is available as a web app at app.echokardio.de — no download required. It works on all devices (PC, tablet, smartphone) directly in the browser.

Yes, calculators marked as "Free" (e.g. TAPSE, RA-/RV, LVEF) can be used without registration. EchoMastery Pro offers a 7-day free trial with access to all 18 calculators.

The congress calendar and courses pages list both German-language and international English-language events. The echokardio.de website is fully available in both German and English.

echokardio.de was developed by Dr. Christian Kirsch — specialist in internal medicine and cardiology, head of cardiovascular imaging at Klinikum Lippstadt, and DEGUM Level II instructor and course director for the Medical Chamber of Westphalia-Lippe. He is the author of "Doppler-Echokardiographie" (Schattauer Verlag, 5th edition).

The calculators and information on echokardio.de are designed to support trained medical professionals and do not replace individual clinical judgment. All data is based on current guidelines — clinical decisions remain the responsibility of the treating physician.