PRospective Evaluation of Electrocardiographic Voltage Changes and Six Minute Walk Test for Predicting Readmissions in Heart Failure (PREEMT-HF Study)

Primary Objective Determine the ability of EKG voltage changes and pre discharge 6-minute
walk test (6-MWT) to predict repeat heart failure hospitalization (HFH) in patients admitted
with acute decompensated heart failure (ADHF).

Secondary Objectives

1. Determine the ability of EKG voltage changes and pre discharge 6-MWT) to predict a
composite of 1 year mortality and HFH in patients admitted with ADHF.

2. Determine the ability of proportionate pulse pressure, orthostatic blood pressure
changes and pre discharge inferior vena cava (IVC) diameter by portable ultrasound to
predict HFH and mortality

Inclusion Criteria:

- Patients > 18 years of age, admitted with a diagnosis of ADHF and fulfilling the
following criteria:

1. Evidence of systemic congestion (manifested by any 2 of the following criteria:
jugular venous distension, edema, pulmonary rales, Left ventricular S3, or
radiographic evidence of pulmonary venous congestion)

2. Elevated Brain natriuretic peptide

3. Need for at least 1 dose of intravenous loop diuretic

Exclusion Criteria:

- Cardiogenic shock, Acute coronary syndromes (patients with mild elevation in troponin
related to heart failure will not be excluded), patients who are admitted for another
principal problem and develop ADHF in the hospital, pregnant females, end stage renal
disease on hemodialysis, expected survival < 6 months.