Acute Heart Failure Patients With High Copeptin Treated With Tolvaptan Targets Increased AVP Activation for Treatment (ACTIVATE)

Exclusion Criteria

• •1. Unable to provide informed consent
• •2. Unable to have 30 day telephone follow up
• •3. Not expected to survive past 6 months
• •4. On Renal replacement therapy or creatinine \>3.5
• •5. History of allergy or intolerance to Tolvaptan
• •6. Suspected Pregnancy
• •7. Cardiogenic Shock
• •8. Participation in any interventional trial in prior 30 days.
• •9. Receiving or planned to receive IV Inotropic therapy
• •10. ACS now or in the past 30 days
• •11. Treatment with IV infusion vasoactive drugs in the hour prior to enrollment
• •12. Temperature \> 100.5
• •13. Heart Failure due to atrial fibrillation with Rapid Ventricular Response
• •14. SBP \< 90 mmHg