Hemodynamic Assessment in Acute Decompensated Heart Failure

Inclusion Criteria:

• Age ≥ 18 years
• Admission to the hospital with a primary diagnosis of acute decompensated heart failure
• Treated with or planned treatment with intravenous diuretics

• Volume overload, as indicated by at least one of the following clinical signs:

  • Peripheral edema
  • Pulmonary edema on physical examination
  • Pleural effusions on chest x-ray
  • Jugular venous distension on physical examination
  • CVP > 10 cmH2O
  • Presence of third heart sound
• Able to understand study procedures, agree to participate in the study program and voluntarily provide written informed consent

Exclusion Criteria:

• Inability or refusal to sign the Subject Informed Consent
• Age > 80 years
• Body mass index (BMI) > 40
• Planned mechanical ventilation during hospitalization
• Presence of left ventricular assist device (LVAD)
• Dialysis
• Pregnancy. All women of childbearing potential must have a negative pregnancy test before enrollment.
• Parenteral diuretic or other medical treatment for ADHF already administered for more than 12 hours prior to enrollment
• Skin damage to the optical sampling sites (fingers and dorsal hand), to include tattoos, scars, cuts, or burns extending over more than 30% of the visible tissue
• Compromised superficial hand veins or proximal venous stenosis
• Intravenous lines connected to both arms
• Inability to stand with support, if needed, for 4 minutes
• Inability to place hand in the venous imaging enclosure due to forearm, elbow, or shoulder injuries, or other physical constraints
• Inability to wear fingertip or ring sensors on three fingers (of either hand) due to missing fingers, injured fingers, or other physical constraints
• Persons in police custody or prisoners
• Major medical or psychiatric condition that would interfere with the ability to complete the study