Intravascular Volume Expansion to Neuroendocrine-Renal Function Profiles in Chronic Heart Failure

Inclusion Criteria: * Acute Decompensated Chronic Heart Failure, diagnosed clinically with volume overload by the primary Heart Failure provider or Emergency Department physician and admitted to hospital. * New York Hear Association functional class III-IVa with stage C or D Heart Failure with Left Ventricular Ejection Fraction \<50% * Intended treatment plan with intravenous loop diuretic therapy during hospitalization * Meeting none of the Exclusion Criteria Exclusion Criteria: * Age \< 18 years * Having received any investigational drug or device within 30 days prior to entry into the study. * Clinically unstable patients (e.g. systolic blood pressure \< 90 mmHg, ongoing requirement for vasopressors or mechanical circulatory support, or mechanical ventilation). * Hospitalization within three months prior to study for hemodialysis or an ongoing requirement for hemodialysis or ultrafiltration. * Prior organ transplantation or being on a waiting list for organ transplantation * Presence of cardiac conditions such as clinically significant cardiac valve stenosis, hypertrophic cardiomyopathy, restrictive cardiomyopathy, constrictive pericarditis, or primary arterial pulmonary hypertension (Group 1 PAH). * History of blood pressure \> 190/115 mmHg or unexplained syncope within the past 3 months. * Symptomatic carotid artery disease, known critical carotid stenosis, or stroke within the past 3 months * Clinically significant intrinsic renal disease (eGFR \<15 ml/min/1.72m2), renal artery stenosis, or history of fibromuscular dysplasia of the renal arteries * Baseline hemoglobin \< 8.5 g/dl, aspartate aminotransferase (AST) or alanine aminotransferase (ALT) that is five times or more the upper limit of normal or bilirubin three times or more the upper limit of normal * History of alcohol abuse within the past 6 months.