Early-start Exercise Training in Subacute Heart Failure

Inclusion Criteria: * history of chronic heart failure for at least 6 months, with ongoing acute decompensation defined as onset or worsening of heart failure signs and/or symptoms during the previous 15 days with need of intravenous diuretic and/or vasodilator therapy; * age \>18 years * left ventricular ejection fraction \<40% * proBNP \>1000 pg/ml at admission Exclusion Criteria: * ongoing cardiogenic shock * need of intravenous inotropic therapy * acute coronary syndrome during the preceding 3 months * clinical and/or instrumental evidence of myocardial ischemia and/or life-threatening arrhythmias * previous cardiac valve surgery * creatinine \>2.5 mg/dl at admission * severe comorbidities limiting functional capacity