Inclusion Criteria:  consecutive consenting outpatients with HFrEF, HFmrHF, HFpEF or PAH, ambulatory visit routinely planned with an echocardiographic examination, at the time of the visit at least moderate FTR diagnosed at echocardiography (by visual assessment), aged ≥ 18 years old, capable to sign an informed consent.  Exclusion Criteria:  age < 18 years old, congenital heart disease, heart failure due to organic mitral or aortic valve disease. No examination will be performed in addition to what is routinely planned for patients' evaluation.