DR REGISTRY: Prospective Observational Study of ADHF Patients With Insufficient Response to Diuretics

Inclusion criteria

• Subject is >18 and < 85 years of age.
• Subject is hospitalized with primary diagnosis of ADHF.
• N-terminal-pro-brain natriuretic peptide (NT-proBNP) ≥1,600 pg/m or BNP≥400 pg/mL.
• Evidence of fluid overload as indicated by 2 or more of the following criteria:

• peripheral edema ≥ 2+
• radiographic pulmonary edema or pleural effusion
• enlarged liver or ascites
• pulmonary rales or paroxysmal nocturnal dyspnea, or orthopnea
• Jugular venous distention > 7 cmH2O
• Subject insufficiently responds to IV diuretic therapy

Exclusion criteria

• Systolic blood pressure <90 mmHg at the time of screening.
• Acute myocardial infarction or acute coronary syndrome or cardiogenic shock or pleural synthesis within past 7 days or cardiovascular intervention within past 4 days.
• Known LVEF < 15% by echocardiography within 1 year prior to enrolment.
• Complex congenital heart disease (e.g., Tetralogy of Fallot subjects, single ventricle physiology).
• Known active myocarditis, hypertrophic obstructive cardiomyopathy, constrictive pericarditis or cardiac tamponade.
• Severe Aortic valvular disorder (i.e., hemodynamically relevant valvular diseases such as severe stenosis \\severe regurgitation) or Severe mitral disease with planned intervention.
• Evidence of active systemic infection documented by either one of the following: fever >38°C/100°F, or ongoing uncontrolled infection (i.e., inflammatory parameters not decreasing despite > 48 hours of antibiotic treatment).
• Moribund subject or subject with severe or deteriorating damage in more than 3 critical body systems, based on investigator's clinical judgement.