Using Allopurinol to Relieve Symptoms in Patients With Heart Failure and High Uric Acid Levels

Inclusion Criteria: * NYHA class II-IV heart failure due to ischemic or non-ischemic cardiomyopathy. * Left ventricular ejection fraction ≤ 40% by echocardiography- Heart failure symptoms for 3 months despite standard treatment. * Serum uric acid level ≥ 9.5 mg/dl. * At least one of the following additional markers of increased risk: Hospitalization, ER visit or urgent clinic visit for heart failure requiring IV diuretics within the previous 12 months; Left ventricular ejection fraction ≤ 25; B-type natriuretic peptide level \> 250 pg/ml Exclusion Criteria: * Hypertrophic or restrictive cardiomyopathy, constrictive pericarditis, biopsy-proven myocarditis, severe stenotic valvular disease, or complex congenital heart disease. * Acute coronary syndrome, PCI or CABG within 3 months. * Current ventricular assist device or ventricular assist device or heart transplant likely within the next 6 months. * Uncontrolled hypertension (i.e., SBP \> 170 mm Hg or DBP \> 110 mm Hg) * Serum creatinine \> 3 mg/dL or estimated GFR \< 20 ml/min. * Evidence of active hepatitis with ALT and AST greater than 3x normal. * Any condition other than HF which could limit the ability to perform a 6-minute walk test * Any diseases other than HF which are likely to alter the patient's global perception of status or quality of life over a period of 6 months. * Receiving treatment with allopurinol currently or within 30 days, or having symptomatic hyperuricemia which requires treatment with allopurinol.