Only a few studies evaluated the RV systolic function in the three categories of HF, regarding the importance of understanding changes in RV function on clinical presentation and outcome; it was essential to understand the prevalence and severity of RV dysfunction among the three groups and the degree of correlation between RV with LV systolic function.

Inclusion Criteria:

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Adult patients of both gender who have the followiong criteria :

(i) symptoms with or without signs of HF (ii) elevated natriuretic peptides (BNP ≥35pg/ mL or NT-proBNP≥125pg/mL) (iii) relevant structural heart disease: left ventricle hypertrophy (left ventricular mass index ≥115 g/m2 for males and ≥95 g/m2 for females) or left atrial enlargement (>34 mL/m2) or diastolic dysfunction (E/e'≥13 and a mean e' septal and lateral wall <9 cm/s) were included.

Then patients were classified according to EF into HFpEF>50%, HFrEF<40% and HFmrEF >40% and <50%

Exclusion Criteria:

Patients with chronic obstructive pulmonary disease history of pulmonary embolism patients with respiratory failure

HFpEF>50%, HFrEF<40% and HFmrEF >40% and <50%