Bedside NT-proBNP Monitoring in Acute Heart Failure

Inclusion Criteria: * Adults aged ≥18 years. * Patients hospitalized in the cardiac intensive care unit (CCU) with a diagnosis of acute decompensated heart failure (ADHF). * Presence of clinical evidence of congestion at admission, including at least one of the following: * Symptoms or signs of volume overload (e.g., dyspnea, orthopnea, peripheral edema, elevated jugular venous pressure). * Pulmonary congestion based on physical examination or imaging findings. * Other clinically recognized evidence of congestion judged by the treating physician. * Patients receiving standard guideline-directed medical treatment for acute decompensated heart failure, including intravenous diuretic therapy according to clinical practice. * Ability to provide informed consent or availability of a legally authorized representative to provide consent. Exclusion Criteria: * Cardiogenic shock or requirement for immediate mechanical circulatory support. * End-stage kidney disease requiring maintenance dialysis or renal replacement therapy at admission. * Acute conditions requiring urgent intervention that may interfere with study assessments, including acute coronary syndrome requiring immediate revascularization or acute pulmonary embolism. * Clinical conditions in which NT-proBNP interpretation is considered unreliable or inappropriate by the investigator. * Expected survival of less than 72 hours, early transfer from the CCU, or inability to complete the core observation period. * Any other co…