Lead Sponsor

Copenhagen University Hospital, Hvidovre

Age

18 - No limit years

Sex

ALL

Healthy Volunteers

No

•Age ≥ 18 years
•Clinical diagnosis of AHF requiring hospitalization
•Systolic blood pressure ≥85 mmHg
•Echocardiographic signs of cardiac dysfunction, by at least one of
•* Left ventricular ejection fraction ≤45%
•* Abnormal left ventricular filling with dilatation of the left atrium
•* Elevated filling pressures (systolic pulmonary artery pressure\>30, dilated vena cava inferior or E/é\>10)
•* Significant left-sided heart valve disease

•Ongoing ventricular taky- or brady-arrythmias or supraventricular arrhythmias with heart rate \> 180 or \< 40 bpm.
•Retinopathy or intraocular lens implantation (contraindication to Valsalva maneuver)
•Recent myocardial infarction or thromboembolic events.
•Intake of sildenafil or vardenafil withing 24 h and tadalafil within 48 h.
•Absolute contraindication for vasodilation using nitroglycerin as assessed by treating physician
•Intravenous administration of furosemide within 2 hours of baseline measurements