Myocardial Performance Index Determined by Tissue Doppler Imaging in Patients with Systolic Heart Failure Predicts Poor Long-Term Prognosis, an Observational Cohort Study.

•Patients with acute heart failure and LVEF ≤ 40% were included.•Echocardiography was performed, and the patients were followed for a mean of 5 years.•Myocardial performance index (MPI) had the strongest association with mortality.•MPI ≥ 0.67 meant a 13-fold higher risk of cardiovascular mortality than MPI < 0.67.•MPI might in the future be included in prognostic score models in heart failure.