Assessment of Biomarkers and Cardiorenal Syndrome in Acute Decompensated Heart Failure With Vasodilator Therapy

Inclusion Criteria: * At least 18 years of age. * Subject must be able to understand the potential risks and benefits associated with the study. * Baseline systolic blood pressure ≥ 90 mm Hg at the time of enrollment. * Clinical symptoms of dyspnea and laboratory admission BNP levels \> 500 pg/mL. * Neither pregnant or breastfeeding at the time of enrollment. * Authorization of patient's enrollment by patient's medical provider. Exclusion Criteria: * \<18 years of age * Denies written informed consent * Pregnant or lactating. * Baseline systolic BP \< 90 mmHg or cardiogenic shock * No symptoms of congestion or admission BNP \< 500 pg/mL * Known allergy to E.coli-derived products, or any history of anaphylactic reactions to nesiritide. * Receiving dialysis at the time of enrollment. * Serum creatinine \> 2.5 mg/dL at the time of enrollment.