Is universal grading of diastolic function by echocardiography feasible?

Quantitation of diastolic function centers on the assessment of active and passive ventricular properties, and involves measurement estimates of ventricular relaxation, and chamber and myocardial stiffness. Diastolic dysfunction is a propensity to develop increased left ventricular (LV) end-diastolic pressure. Recently American Society of Echocardiography and European Association of Cardiovascular Imaging (ASE/EACVI) proposed a new grading system. While the new guidelines are ambiguous and with cutoff points that may misclassify patients as both sicker and healthier than they are. This article outlines the pathophysiology behind the diastolic dysfunction and role and limitation of echocardiographic assessment in predicting LV diastolic dysfunction.