Clinical Research Directory

Inclusion Criteria: 1. Age \> 21 years of age 2. Left ventricular ejection fraction ≤ 50% (at any time in the past) 3. Symptomatic (NYHA class II-IV) heart failure (as diagnosed by clinician, radiographic images, or abnormal natriuretic peptide level) 4. Hospital admission, Emergency Department visit, or outpatient diuretic escalation of therapy for destabilized HF at least once in the 6 months prior to enrollment Exclusion Criteria: 1. Severe renal insufficiency defined as serum creatinine \> 2.5 mg/dl 2. United Organ Network Sharing status 1B for heart transplantation (outpatient inotrope use, LV assist device) 3. Inoperable aortic valvular heart disease 4. Life expectancy \<1 year due to causes other than HF such as advanced cancer 5. Cardiac transplantation or revascularization indicated or expected within 6 months 6. Severe obstructive or restrictive pulmonary disease, defined as a forced expiratory volume in 1 sec \<1 L (when diagnosed as standard of care) 7. Subject unable or unwilling to provide written informed consent 8. Coronary revascularization (percutaneous coronary intervention or bypass surgery) within the previous 3 months