Right ventricular (RV) assessment has been a long time endeavour but difficult for many reasons, anatomic physiologic and imaging. Recently, new approaches have allowed better understanding of the how-to for RV evaluation providing new insights in a number of conditions.^1,2 Right ventricle failure and severe tricuspid regurgitation (TR) have been associated with outcomes following therapy.³ The latest published data demonstrate that worsening RV function and its ratio to pulmonary pressure are common and significantly associated with an increased risk of heart failure (HF) hospitalizations and cardiovascular death in patients with heart failure with preserved EF.⁴