All consecutive hospitalized adult heart failure patients who fulfill one of 1-3 and satisfy 4-5 simultaneous  Inclusion Criteria:  Symptoms of heart failure Signs of heart failure Lung congestion in Chest-X-ray Objective finding of structural and/or functional disorder of the heart or elevated natriuretic peptide levels Left ventricular ejection fraction less than 40%  Exclusion Criteria:  Patients younger than 19 years old Patients who do no consent