Despite advances in the pharmacological and device therapies for heart failure (HF), readmission of patients poses a significant medical burden and remains an area for improvement.1, 2, 3, 4, 5 Reliable prognostic information regarding readmission for hospitalized patients with HF would help physicians to better manage patient therapy and guide future research into reducing HF readmission rates.5 Pathophysiologically, elevation of left ventricular (LV) filling pressure is the major reason for HF readmission; thus, it is important to detect pre-clinical congestion prior to overt clinical symptoms of congestion in HF patients.1 Direct measurement of pulmonary capillary wedge pressure (PCWP) is regarded as the “gold standard” for evaluating LV filling pressure; however, there has been a reduction in hemodynamic assessments using right-sided cardiac catheterization because of the invasive nature of this technique. Instead, Doppler echocardiography plays a vital role to estimate LV filling pressure noninvasively and many studies including our own have examined the correlation between echocardiographic parameters and invasively measured LV filling pressures.6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18 The most established parameter appears to be E/Eʹ, although this measure is not strongly correlated with invasively measured LV filling pressure.6 To this end, the 2016 American Society of Echocardiography (ASE)/European Association of Cardiovascular Imaging (EACVI) guidelines provide an echocardiographic assessment of LV filling pressure and diastolic dysfunction grade by combining several parameters.19,20 Of note, diastolic dysfunction and HF with preserved ejection fraction (EF) are not identical, and the 2016 ASE/EACVI guidelines provide a simple algorithm for estimating left atrial pressure (LAP) based on LV filling pressure and grading LV diastolic function in HF patients irrespective of LVEF.6,19,20 In this way, all HF patients are divided into grade I–III diastolic dysfunction and the indeterminate groups and patients in the grade II and III groups are considered to have elevated LAP.19,20 Although this proposed algorithm is simple and user friendly, its strength in clinical terms is not well validated, and in particular, there is a paucity of prognostic data. Accordingly, the present clinical study evaluated the echocardiographic assessment of elevated LAP based on the 2016 ASE/EACVI guidelines for predicting readmission within one year for HF patients.