A Prospective Evaluation of Natriuretic Peptide Based Referral of CHF Patients in Primary Care

Inclusion Criteria: * Willing and able to provide written informed consent and accept study procedures and time schedule. * Age ≥ 18 years. * Patients suffering from chronic heart failure (the heart failure diagnosis must have been made or confirmed by a cardiologist and/or hospital physician at any time in the patient's medical history). * Patients with reduced ejection fraction (≤ 40%) as confirmed at any time point in the patient's medical history. Exclusion Criteria: * Use of investigational drugs either within 5 half-lives of enrollment, or within 30 days, or until the expected pharmacodynamic effect has returned to baseline, whichever is longer. * Major surgery in the last 3 months prior to baseline or planned major surgery or cardiac intervention during the study. * Cancer or other significant co-morbidities implying that the patient's condition is unstable. * Comorbidities that can be associated with elevated natriuretic peptide (NP) levels: renal insufficiency, (eGFR \< 25 ml/min/1.73 m² calculated according to MDRD formula), recent (less than 3 months) cerebral trauma or recent (less than 3 months) cerebrovascular incident, novel diagnosis or acute exacerbation of COPD within the last 3 months. * Patients who are primarily managed and regularly followed-up by a cardiologist for their HF * Highly frail patients whose estimated lifespan due to comorbidities by the judgement of the investigator is less than 6 months.