Background: Diastolic function of left ventricle(LV) reflects chamber remodeling in early phase after acute coronary syndrome(ACS). Nevertheless numerous noninvasive diastolic parameters by transthoracic echocardiography, there was few studies about best predictive one for predicting invasive left ventricular end diastolic pressure(LVEDP). So we investigated the independently correlated noninvasive diastolic parameters predicting LVEDP in acute phase of ACS patients. Methods: Thity-five consecutive patients with ACS underwent echocardiography on 5~9 days after event. Various Doppler echocardiographic parameters and LA volume was measured on the study. And at the same day just after the study, left heart catheterization with recording of LVEDP was performed. Results: Patients(69% Male; mean age 61짹12 years) showed moderately decreased LV systolic functions(EF=44.5짹10.8%) and elevated LVEDP(25.6짹8.0mmHg). Transmitral E/A ratio(E/A), peak velocity of pulmonary venous atrial reversal flow(peak PVAFR) and transmitral peak E velocity/mitral annular E' velocity(E/E') showed significant linear correlation with LVEDP(r=0.549 and P=0.001, r=0.471 and P=0.006, and r=0.375 and P=0.031, respectively). And also deceleration time of transmitral E wave showed distinct but statistically insignificant linear correlation with LVEDP(r=-0.330, p=0.06), but the difference of duration between mitral A wave and PVAFR and systolic fraction of pulmonary venous flow didn���t. Conclusions: E/A, peak PVAFR and E/E' may be the independently correlated noninvasive diastolic parameters predicting LVEDP and reflecting LV remodelling in acute phase of ACS patients.