Inclusion and exclusion criteria
Patients with recent onset (within three months) heart failure with reduced ejection fraction (less than 45%).
Patients with peripartum heart failure, cardiogenic shock, chronic heart failure, Anthracyclin-induced heart failure, patient with Acute STEMI ,patients who refuse to participate in this study, and Patients with poor acoustic window will be excluded from the study.
Full history and examination, Q minneosta questionnaire, troponinI was withdrawn and they all underwent echocardiography with speckle tracking on the left side ,right side volumes and fractional area change and follow –up after 3-6 months., where all values with indexed to body surface