Geenen LW, van Grootel RWJ, Akman K, et al. - Given a high risk of cardiac complications in adults with a systemic right ventricle (sRV), researchers investigated prognostic markers in this patient population based on clinical assessment, echocardiography, and blood biomarkers in this prospective cohort study. Participants (n = 86) aged 37±9 years were observed over a median duration of 5.9 years, during which, death or heart failure (primary endpoint) was reported in 19 (22%) patients and death or arrhythmia (secondary endpoint) in 29 (34%) patients. Associations of New York Heart Association functional class > I, systolic blood pressure, and most blood biomarkers, with the primary and secondary endpoints were evident. The association of growth differentiation factor-15 with both endpoints was the strongest. A link between end-diastolic basal dimension of the subpulmonary ventricle and both endpoints was also noted. Findings highlighted the significance of clinical, conventional echocardiographic, and blood measurements as markers for risk stratification in adults with a sRV. A seemingly limited value of new echocardiographic strain analysis was observed.