Agrawal V, D'Alto M, Naeije R, et al. - Given the often requirement of invasive right heart catheterization with provocative maneuvers such as fluid challenge for identification of occult diastolic dysfunction, researchers examined if echocardiographic measures of diastolic function could be related with occult diastolic dysfunction identified at catheterization. Hemodynamic and echocardiographic data from consecutive patients referred for right heart catheterization with fluid challenge from 2009 to 2017 were retrospectively examined. Fifty-two patients who underwent simultaneous echocardiogram and right heart catheterization (RHC) before and after fluid challenge at Monaldi Hospital, Naples, Italy, formed the prospective cohort. A total of 126 patients (83% female, 56+14 years) in the Vanderbilt cohort met the inclusion criteria. The analysis revealed the association of 2 echocardiographic measures of diastolic function, mitral in-flow velocity (E) velocity and the ratio of mitral in-flow to mitral annular tissue doppler velocity (E/e′), with occult diastolic dysfunction in patients with pulmonary hypertension. Routine echocardiographic measurements thus seem to have the potential for assisting identification of patients like to have occult diastolic dysfunction non-invasively.