Rationale for a widespread use of the spectral tissue Doppler-derived E/E' despite its failure to closely predict invasively measured left ventricular diastolic pressures.

Recent studies have questioned the reliability of the spectral tissue Doppler-derived E/E' ratio in the assessment of left ventricular diastolic pressures in the individual patient. It appears therefore of clinical importance to highlight that E/E' provides useful clinical information for the diagnosis of heart failure as well as risk stratification in multiple clinical settings, regardless of its ability to closely predict invasively measured left ventricular diastolic pressures.