The primary objective of the study is to determine efficacy of metolazone as synergistic therapy with Lasix in patients with acute decompensated heart failure. This will be a multicenter double blinded randomized placebo- controlled pilot study of the addition of 5 mg of metolazone per day for 2 days compared to placebo in patients admitted with acute decompensated heart failure.
AS DESCRIBED BY THE PRINCIPAL INVESTIGATOR (DR. HEYWOOD): The primary objective of the study is to determine efficacy of metolazone as synergistic therapy with Lasix in patients with acute decompensated heart failure. This will be a multicenter double blinded randomized placebo- controlled pilot study of the addition of 5 mg of metolazone per day for 2 days compared to placebo in patients admitted with acute decompensated heart failure.
Admitted with acute decompensated heart failure based on history, physical exam, and laboratory parameters, must include both:
At least 1 symptom of either dyspnea, orthopnea, or edema. At least 1 sign of rales on auscultation, peripheral edema, ascites, or pulmonary vascular congestion on chest radiography. Be willing to comply with protocol-specified instructions Able to understand and grant informed consent.
Exclusion Criteria:
Inability to give informed consent. Systolic BP < 90 mmHg Creatinine clearance less than 20ml/min or creatinine greater than 2.5mg/dl. Serum Sodium less than 128meq/L, potassium levels less than 3.5meq/L Known adverse reaction to metolazone Inability to take oral medications Severe Aortic Stenosis (AVA < 0.8cm³) History of Hypertrophic Obstructive Cardiomyopathy. Metastatic Carcinoma Severe Chronic Obstructive Pulmonary Disease (COPD), FEV < 1L Severe dyspnea requiring prolonged CPAP or intubation Moderate/Severe Dementia
