Ultrafiltration Versus IV Diuretics in Worsening Heart Failure

Inclusion Criteria:

• 18 years or older

• Man, or non-pregnant woman

• Admitted to the hospital with a diagnosis of acute decompensated heart failure

• On regularly prescribed oral loop diuretics, Sodium-glucose Cotransporter-2 (SGLT2)Inhibitors or a Mineralcorticoid Receptor Antagonists (MRA) prior to admission

• Fluid overload manifested by at least three clinical indications (e.g., edema, anexcess of at least 10 pounds of fluid, etc.)

• Provide written informed consent

Exclusion Criteria:

• New diagnosis of heart failure

• Acute coronary syndromes

• Creatinine ≥ 3.0 mg/dl or planned renal replacement therapies at the time ofenrollment

• Contraindications to systemic anticoagulation

• Severe concomitant disease expected to prolong hospitalization or cause death inless than 90 days

• Sepsis or ongoing systemic infection

• Active myocarditis

• Constrictive pericarditis or restrictive cardiomyopathy

• Severe aortic stenosis

• Any condition in the opinion of the investigator that would prevent the patient fromfollow-up/survival