TARGET-LOAD Pilot Study Comparing Hemodynamics-guided LVAD Unloading Vs. Standard of Care

Inclusion Criteria: * Severe clinical HF resistant to intensive medical therapy and requiring LVAD implantation * Left ventricular ejection fraction \<=25% and cardiomegaly at time of LVAD implantation * Non-ischemic etiology of HF * Undergone LVAD implantation within prior 4 weeks or planned for LVAD implant * History of HF \< 5 years * Body Mass Index \<=35 kg/m\^2 * Pulmonary artery branch diameter between 7 - 15 mm * Female subjects of childbearing age with negative urine or serum pregnancy test and agreeing to use reliable mechanical or hormonal form of contraception during study Exclusion Criteria: * Evidence of active acute myocarditis confirmed by histology * History of previous cerebrovascular accident resulting in significant fixed motor deficit, limiting ability to perform exercise testing * Implanted mechanical aortic and/or mitral valve(s) and/or right heart valve(s) * Aortic valve closure * Hypertrophic obstructive cardiomyopathy or sarcoidosis * Left ventricular end-diastolic diameter below normal (restrictive cardiomyopathy) * Irreversible multi-organ failure * Diagnosis of psychiatric disease, irreversible cognitive dysfunction or poor psycho-social issues likely to impair compliance with study protocol * Any condition that could limit survival to less than 2 years * History of cardiac or other organ transplant * Contraindicated to anti-coagulation, antiplatelet therapy, or diagnosis of coagulation disorders * Require acute or chronic renal replacement the…