Objective: To study the prediction of FWLS by RT-3DE on the heart function of CHF patients. Methods: 84 patients with heart failure admitted to our hospital from March 2019 to January 2020 were selected, and healthy patients who were undergoing physical examination in our hospital during the same period were selected as the control group (60 cases). All subjects underwent RT-3DE examination and compared the FWLS and cardiac function indexes of the two groups of subjects. All subjects underwent RT-3DE examination, and the FWLS and cardiac function indexes of the two groups were compared. Pearson correlation analysis was used to analyze the correlation between FWLS and cardiac function indexes, and the ROC curve was used to analyze the clinical value of FWLS in the diagnosis of CHF. Results: There were significant differences in serum NT proBNP level and real-time three-dimensional echocardiography parameters between the two groups (P < 0.05). NT proBNP, RVESV, RVEDV in the study group were significantly higher than those in the control group, while RVSV, RVEF, LVEF, FWLS in the study group were significantly lower than those in the control group (P<0.05). Pearson correlation analysis showed that FWLS was positively correlated with RVSV, RVEF, and LVEF (r=0.484, 0.491, 0.533, P<0.001), but there was no significant correlation with RVESV and RVEDV(P>0.05). Logistic regression analysis showed that NT-proBNP (OR=4.679; 95%CI=1.580~13.858), RVSV (OR=2.601; 95%CI=1.245~5.436), RVEF (OR=2.241; 95%CI=1.305~3.850), LVEF (OR=1.790; 95%CI=1.318~2.430) and FWLS (OR=2.000; 95%CI=1.315~3.042) are risk factors for CHF (P<0.05). ROC curve analysis showed that the area under the curve for FWLS diagnosis of CHF was 0.866 (95%CI=0.792~0.920), the sensitivity and specificity were 81.70% and 77.40%, respectively, and the area under the curve for NT-proBNP diagnosis of CHF was 0.803 (95%CI=0.730~0.876), the sensitivity and specificity were 79.80% and 73.30%, respectively. The area under the curve of FWLS was higher than that of NT-proBNP (P<0.05). Conclusion: RT-3DE can accurately reflect the abnormal state of the right ventricle in patients with CHF. The FWLS is an independent risk factor for CHF patients, which has advantages in evaluating the cardiac function of CHF patients.