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Introduction: RV dysfunction in heart failure patients due to LV systolic impairment has worst prognosis.Objective: Evaluate Nt-ProBNP relation with RV global function in patients with LV systolic impairment heart failure.Methods: 100 pts (60% M), age 72.5±10 years old regularly followed in a heart failure clinic, ejection fraction (EF) of the left ventricle (LV) 30.78±9.5%, cardiac output 4.25±1.59, Nt-ProBNP median 1337.0 pg/ml, LV end diastolic diameter 6.82±0.97 cm. Nt-ProBNP determined and RV longitudinal global strain (GS) and strain rate (GSR), tricuspid TDI S, E and A waves, RVEF, right atrium EF (RAEF) and pulmonary arterial systolic pressure (PASP) evaluated. Relationship between parameters evaluated with Spearman correlation coefficient and linear regression model (backward method). Nt-ProBNP grouped accordingly to the quartiles (596.0; 1337.0; 4287.5).Results: Nt-ProBNP correlated with: (1) RV systolic function: RVEF (r=0.357 p=0.001), Tr-S (r=-0.273 p=0.046), RV-GS (r= -0.242 =0.031). (2) RV diastolic function: RAEF (r=-0.346 p=0.001), TrA (r=-0.316 p=0.047), RV-GSRa (r=-0.294 p=0.029). (3) PASP (r=0.340 p=0.006). (4) By multiregression the Nt-ProBNP was independently associated with PASP (p=0.005), Tr-S (p=0.001) and RAEF (p= 0.021). (5) Greater the Nt-ProBNP quartile (see table) greater the PASP and worst the RV global function.Conclusion: In heart failure patients Nt-ProBNP reflects RV pressure overload and RV systolic dysfunction.