A Prospective, Single-center, Randomized, Controlled, Open-label, Pilot Study to Compare the Effectiveness and Safety of DIuretics Add-On Strategy in Acute Decompensated Heart Failure Patients (DIOS II)

Inclusion Criteria: 1. dyspnea at rest or minimal activity 2. tachypnea (respiratory rate \> 20/min) or rales or pulmonary edema on chest X-ray Exclusion Criteria: 1. hospitalization for acute heart failure decompensation 2. cardiogenic shock (Systolic Blood Pressure \< 80mmHg) 3. Need or plan for renal replacement therapy (dialysis, kidney transplant) 4. serum creatine level \> 2.5mg/dl 5. serum potassium (K+) \> 5.5mg/dl 6. Age \> 80 years old or poor compliance patients 7. allergy, adverse drug reaction, hypersensitivity to any kinds of diuretics 8. life expectancy \< 6 months (e.g. metastatic malignancy, liver cirrhosis) 9. pregnancy or women at age of childbearing potential