Is It Time to Redefine the FMR Phenotype?: The Essential Integration of Morphology, Strain, and Hemodynamics

• Diastolic assessment is essential in every TTE exam. • Accurate estimation of LV filling pressures requires integration of multiple parameters. • Triphasic mitral inflow with an L wave may be seen in severe diastolic dysfunction. • PVC with R-R prolongation can help unmask and confirm L wave. • Clinical context is key to accurate assessment.