TransitionCHF Systolic Dysfunction to Congestive Heart Failure Cohort Study

Inclusion Criteria: * Asymptomatic systolic dysfunction (defined as: ejection fraction \< 40% by echocardiography or MRI; documented within the last 3 months prior to baseline visit) * A maximum of one hospitalization for heart failure (defined as hospitalization with signs and symptoms of heart failure requiring intravenous loop diuretic therapy within 48 hours after hospital admission) at least 2 years prior to the baseline visit * No heart failure symptoms (NYHA II, III or IV) upon inclusion * 6MWD ≥ 80% of reference values * Written informed consent * Age ≥ 18 years Exclusion Criteria: * Symptomatic heart failure (NYHA\>I) at baseline visit * Any significant valvular disease (\> 2nd degree) * Severe pulmonary disease (e.g. FEV1/FVC \<0.7 and FEV1\<50%) * Severe renal disease (GFR \< 15 ml/min) * ejection fraction at baseline visit ≥ 50% by echocardiography or MRI * Life expectancy \< 1 year * Pericardial disease * Hypertrophic cardiomyopathy * Myocardial infarction within the last 3 months * Planned cardiac surgical intervention within 3 months after inclusion * Geographical reasons (e. g. patients living outside Germany or planning to move abroad) * Inability to give informed consent (e. g. mental disorders) * Therapy with loop diuretics (e.g. torasemide, furosemide, piretanide) within 4 weeks prior to inclusion/baseline visit