CRF2 Agonist for the Treatment of Worsening Heart Failure

Inclusion Criteria:

• Signed written informed consent

• Heart failure hospitalization (HFH) during previous 12 months

• Prescribed an oral loop diuretic for at least 1 month preceding the index event

• NT-proBNP ≥1,000 pg/mL or BNP ≥250 pg/mL

• Requires treatment with i.v. diuretics for volume overload

• At least 1 risk factor for diuretic resistance

• Admitted to the hospital not more than 48 hours prior to randomization

Exclusion Criteria:

• Index event primarily triggered by an acute event (e.g. AMI, PE, arrhythmia)

• Requirement for i.v. inotropic therapy or i.v. vasodilators, mechanical ventilation,high-flow oxygen therapy, or NIV

• Requirement for, or planned use of LVADs, IABP, or any type of MCS

• History of solid organ transplant or active on a transplant list

• SBP <100 mmHg

• eGFR < 20 mL/min/1.73 m2

• CABG, PCI, implantation of CRT, heart valve procedure or any cardiac surgery within 1 month prior to screening or planned during the study

• Severe stenotic cardiac valvular disease

• Severe chronic pulmonary disease requiring chronic steroid therapy or chronic oxygentherapy (> 2 L/min)

• Uncorrected severe hyperthyroidism or hypothyroidism

• Severe restrictive, obstructive, or infiltrative cardiomyopathy

• Body weight < 70 kg

• Use of any investigational drug(s) within 5 half-lives of screening

• At high risk of death (defined as life expectancy ≤1 year) from causes other thanheart failure or any disease that, in the opinion of the Investigator, will precludetheir safe participation in this study, and will make implementation of the protocolor interpretation of the study results difficult

• Presence of any other conditions (e.g. geographic, social) actual or anticipated,that the Investigator feels would restrict or limit the subject's participation orcompliance with all study procedures Subject is the Investigator or anySubinvestigator, research assistant, pharmacist, study coordinator, other staff orrelative thereof directly involved in the conduct of the study