Assessment of left ventricular diastolic function by echocardiography involves evaluating mitral inflow velocities with pulsed wave Doppler (E and A waves), pulmonary venous flow patterns (systolic and diastolic waves), and tissue Doppler imaging of the mitral annulus to measure early diastolic (e') velocities.

This combination allows differentiation of normal versus abnormal relaxation, elevated filling pressures, and grading of diastolic dysfunction. The myocardial performance index evaluates global ventricular function but does not specifically require these Doppler measures. Systolic function is assessed mainly by ejection fraction and wall motion. Mitral regurgitation severity uses color Doppler and vena contracta measurements.

This multiparameter diastolic function evaluation is outlined in the "Textbook of Clinical Echocardiography, 6e", Chapter on Diastolic Function Assessment【20:210-220†Textbook of Clinical Echocardiography】.