Circulating RNAs in Acute Heart Failure (CRUCIAL)

The purpose of this American Heart Association-funded and NIH-funded study is to examine circulating RNAs in the acute congestive heart failure (CHF) setting, and how they change with decongestive therapy, and their function in vitro and in vivo. The investigators are testing the hypothesis that ex-RNA levels change significantly during decongestion therapy and can be used as a marker of those individuals who respond to CHF therapy (in terms of cardiac structure or outcome). Additionally, the translational research design allows the investigators to assay the effects of these RNAs on tissue phenotypes in vitro.]]>
Inclusion Criteria:Age >= 18 years of ageAssessment of left ventricular (LV) function within the last year or planned during hospital admission3. Acute CHF diagnosis, requiring clinical signs and/or symptoms (including exertional or rest dyspnea, orthopnea or PND) anda. N-terminal pro-BNP level > 1000 pg/ml or BNP > 400 pg/ml, orb. Clinical evidence of congestion:X-ray evidence of pulmonary edema or pleural effusionsElevated Jugular venous pressure (JVP), lower extremity edema, or rales on pulmonary examinationRight heart catheterization evidence of elevated filling pressures (RA pressure > 10 mmHg; PCWP > 18 mmHg)4. Clinical response to IV diuretic therapy (as judged by a physician)Exclusion Criteria:Hematocrit at time of consent < 30%2. End-stage non-cardiovascular diseasesa. Known HIV/AIDSb. Cirrhosisc. Hemodialysis-dependent renal failure3. Pregnancy (as adjudicated by patient history)4. Ventricular assist device support5. Acute mechanical support on admission6. Post-heart transplant7. Malignancy within the last 1 year or clinically active rheumatologic or autoimmune illnesses]]>