An Observational Study of the Functional Capacity of Heart Failure

This observational study will evaluate the functional capacity (ability to walk and distance
walked) of patients with Heart failure with Reduced Ejection Fraction (HFrEF) in
approximately 50-70 patients who present with Acute Heart Failure to approximately 5-6
hospital sites in the USA. All enrolled patients will be evaluated for their baseline
functional capacity. Patients will receive standard Acute Heart Failure therapy and will be
serially assessed for change in their functional capacity.

Inclusion Criteria:

- Have a left ventricular ejection fraction (LVEF) ≤40%, as assessed by any method,
e.g., echocardiography, a multigated acquisition (MUGA) scan or magnetic resonance
imaging (MRI);

- Present with signs and symptoms considered to be primarily due to AHF and be admitted
to the hospital for AHF;

- Confirmation verbally that the patient was ambulatory, i.e., able to walk >30m, prior
to developing symptoms of AHF leading to the current admission;

- Be capable of understanding the nature of the trial; be willing and able to comply
with the inpatient and outpatient study protocol requirements for the duration of the
study; and be willing to participate, as documented by written informed consent.

Exclusion Criteria:

- Have a systolic blood pressure <90mmHg or >170mmHg at baseline;

- Have an anticipated need for an invasive procedure within 3 days of study enrollment,
e.g., due to hemodynamic or cardiac rhythm instability, or acute coronary syndrome,
requiring procedures including, but not limited to, cardiac catheterization,
placement of a defibrillator/pacemaker, or placement of a pulmonary artery catheter;

- Have a primary HF etiology attributable to either restrictive/obstructive
cardiomyopathy, idiopathic hypertrophic cardiomyopathy (as defined by any wall
thickness > 1.8cm) that is obstructive, or uncorrected severe valvular disease
(except mitral regurgitation);

- Have any other comorbidities that limit ambulation more than the patient's heart
failure, e.g., symptomatic peripheral arterial disease, COPD, arthritis or other
condition, as confirmed verbally with the patient;

- Have severe renal insufficiency (defined as a GFR <30mL/min/1.73m2 according to the
MDRD equation);

- Have an anticipated survival of less than 90 days, for any reason;

- Have received an investigational agent (drug, device or biologic product) within 30
days (or, if longer, 5 half-lives for a drug or biologic agent) prior to study entry,
or be planning to receive an investigational agent at any time throughout the full
duration of the study until at least Study Day 35;

- Have any other clinically significant laboratory abnormality, medical condition or
social circumstance that, in the investigator's opinion, makes it inappropriate for
the patient to participate in this clinical trial.