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Objective. The purpose of this study was to assess the state of left ventricular (LV) systolic dysfunction for an extended period after heart transplantation using the parameters of the functional geometry of the left ventricle. Material and Methods. The study included 31 patients after orthotopic heart transplantation with a follow-up period of up to nine years. We used linear discriminant analysis to build a classification model based on either the standard echocardiographic parameters of LV systolic function or parameters of LV functional geometry indexes aimed at the potential prediction of acute rejection and progression of chronic heart failure. Results. The linear discriminant analysis model based on parameters of LV functional geometry showed a high predictive value to diagnose acute rejection and development of heart failure in heart transplant patients. Conclusion. Linear discriminant analysis classification model based on the LV functional geometry data showed high accuracy in predicting allograft rejection and development of heart failure in heart transplant patients. © 2022 Industrial Laboratory. Materials Diagnostics. All rights reserved. ; The work was carried out within the framework of state assignments for the Ural State Medical University of Minzdrav of Russia (theme № AAAA-A18-118051590064) and Institute of Immunology and Physiology, Ural Branch of the Russian Academy of Sciences (theme No AAAAA18-118020590031-8). This work was supported by Decree of the Russian Government №211 of March 16, 2013 (agreement 02.A03.21.0006).