VAPorized Administration of Bumetanide for Outpatient Relief in Heart Failure

Inclusion Criteria: * Age ≥ 18 y with chronic HF (NYHA II-III). * Successful CardioMEMS or Cordella implantation ≥ 3 months prior. * Clinically mild or worse congestion (no IV diuretics within 7 days). * eGFR ≥ 20 mL/min/1.73 m²; serum K⁺ 3.5-5.2 mmol/L. Exclusion Criteria: * SBP \< 90 mmHg, HR \< 50 bpm, or \> 110 bpm at baseline. * Acute HF hospitalization \< 30 days. * Chronic nasal pathology or recent intranasal surgery. * Known allergy to bumetanide or sulfamides. * Pregnancy or lactation. * Participation in the active treatment or follow-up phase of another clinical study of an investigational drug or device which has not reached its primary endpoint.