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Heart failure is a clinical diagnosis that is supported by various laboratory, imaging, and invasive hemodynamic measures. There is no single diagnostic test. A variety of structural and/or functional myocardial abnormalities can lead to the inability of the heart to fill or eject blood. Despite ejection fraction being the most commonly assessed measure of systolic function in clinical practice, it is a poor measure of contractility because it is susceptible to loading conditions and chamber size. Invasive hemodynamic assessment remains of great importance in the evaluation of patients with myocardial disease or hypertrophic cardiomyopathy.