Fluid Restriction in Heart Failure Versus Liberal Fluid Uptake

Inclusion Criteria:

• Diagnosis of chronic HF with NYHA class II/III according to the prevailingguidelines > 6 months prior to randomization (1)

• Adult (age ≥ 18 years)

Exclusion Criteria:

• Reversible cause of HF (thyroid disorders, severe anemia, vitamin deficiencies)

• Hospital admission for HF within 3 months of randomization

• Chronic HF with NYHA class IV

• Hyponatremia at baseline (sodium <130mmol/l)

• Changes in HF medical therapy in last 14 days prior to randomization

• Estimated Glomerular Filtration Rate (eGFR) of < 30ml/min/1.73 m2 at baseline

• Scheduled cardiac surgery within 3 months of randomization

• Recent (within 3 months) coronary intervention (PCI or CABG) or implantation ofpacemaker device

• Comorbidity for which fluid restriction is advised by a different treating physician (e.g. nephrologist)

• Comorbidity with a life expectancy of less than 6 months

• The treating clinician believes that participation in the domain would not be in thebest interests of the patient

• Inability to provide informed consent