Reference values, standards, and what Pro actually adds.

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.

Open 2D calculator (LVEF) →

An LVEF of 60% is normal. Classification: normal ≥52% (men) / ≥54% (women), mildly reduced 41–51% (men) / 41–53% (women), moderately reduced 30–40%, severely reduced <30%.

Open 2D calculator (LVEF) →

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.

Open aortic stenosis calculator →

Diastolic Dysfunction (ASE 2025): EF-independent. The algorithm is based on e′, E/e′, and TR velocity/PASP. Goal: estimate left atrial pressure (LAP), then grade.

Step 1 — baseline variables:

• e′ average reduced (< 6.5 cm/s — impaired relaxation)
• E/e′ average elevated (> 14)
• TR velocity ≥ 2.8 m/s / elevated PASP

Grading (by LAP + E/A): Grade 1 = normal LAP, usually E/A ≤ 0.8 · Grade 2 (pseudonormal) = elevated LAP + E/A < 2 · Grade 3 (restrictive) = elevated LAP + E/A ≥ 2.

Open diastolic function calculator →

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.

Read the step-by-step guide →

The TAPSE/PASP ratio reflects right ventricular–pulmonary arterial (RV–PA) coupling. Normal value: > 0.36 mm/mmHg. Values between 0.3 and 0.4 mm/mmHg indicate impaired RV–PA coupling and represent an important prognostic parameter in pulmonary hypertension.

Open RA/RV calculator →

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. Relative wall thickness (RWT) is used for morphological classification into concentric or eccentric hypertrophy.

Open LV mass calculator →

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.

Open 2D calculator (LA volume) →

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.

Open mitral stenosis calculator →

Mitral Regurgitation severity (ASE 2017): A transmitral E/A ratio (PW Doppler) < 1 generally argues against severe MR, as does a non-holosystolic jet. Otherwise, assess integratively using six criteria: flail leaflet, dilated LV with preserved EF, MR jet occupying >50% of the left atrium (central jets), vena contracta > 7 mm, PISA radius > 10 mm (aliasing 30–40 cm/s), systolic flow reversal in ≥2 pulmonary veins. Severe if ≥4 criteria are met, or ≥3 criteria plus EROA ≥ 0.3 cm² / regurgitant volume ≥ 45 mL, or ≥2 criteria plus EROA ≥ 0.4 cm² / regurgitant volume ≥ 60 mL.

Open mitral regurgitation calculator →

Per ESC/EACVI (Eur Heart J 2025), for severe primary MR — Class I (surgery/repair preferred): symptomatic, operable MR; asymptomatic MR with LV dysfunction (LVEF ≤60% or LVESD ≥40 mm/≥20 mm/m²); or asymptomatic MR with preserved LV function plus ≥3 of 4 criteria (atrial fibrillation, resting sPAP >50 mmHg, LAVI ≥60 mL/m² or LA diameter ≥55 mm, concomitant ≥moderate secondary TR). Class IIa: preserved LV function with AF or sPAP >50 mmHg alone, or significant LA dilatation with a high likelihood of durable repair.

Open mitral regurgitation calculator →

Severity is assessed integratively across 7 criteria: TV annulus dilation (>21 mm/m²) without coaptation/flail leaflet, RV size, CWD jet pattern (dense, triangular, or sine-wave), central jet (≥50% of RA area), PISA radius (≥0.9 cm at 30 cm/s Nyquist), systolic hepatic vein flow reversal, and vena contracta width (≥0.7 cm). TR is graded severe when ≥4 of 7 criteria are met; a 3-vs-3 tie is resolved by vena contracta width.

Open tricuspid regurgitation calculator →

The Aortic Dissection Detection Risk Score (ADD-RS) scores 3 categories — high-risk conditions, pain features, exam findings — at 0–1 point each (total 0–3). ADD-RS ≥2 is high risk: urgent CT angiography (neck to pelvis), with focused TTE/ECG in parallel as needed. ADD-RS <2 (0 or 1) is low risk, and next steps depend on POCUS, chest X-ray, and D-dimer results — if all three are negative, acute aortic syndrome is unlikely.

Open ADD-RS calculator →

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.

View guidelines overview →

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.

Open 2D calculator →

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.

View guidelines overview →

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.

Open app.echokardio.de →

Yes, calculators marked "Free" (e.g. RA-/RV incl. TAPSE, 2D incl. LVEF, ADD-RS) can be used without registration. EchoMastery Pro offers a 7-day free trial with access to all 22 calculators.

View all 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.

View courses →

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).

About Dr. Kirsch →

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.