The purpose of this study is to examine the efficacy of three doses of prednisone, a glucocorticoid, in treatment of patients with symptomatic heart failure.

Heart failure is a leading cause of cardiovascular morbidity and mortality in the world. Most patients with acute symptomatic heart failure are admitted with fluid overload. Intravenous loop diuretics are an essential component of current treatment in such patients. Newly emerging evidence showed that glucocorticoids could potentiate natriuretic peptides' action by upregulating the expression natriuretic peptide receptor A (NPR-A) in the kidney, and produce a potent diuresis. Therefore, the investigators designed this nonblinded, randomized dose comparison study to compare the efficacy of prednisone at 15, 30 and 60 mg/day in patients with in symptomatic heart failure.

Inclusion Criteria:

• hospitalized for symptomatic heart failure
• dyspnea at rest or with minimal activity
• NT-proBNP > 1000pg/ml
• LVEF ≤ 40%

Exclusion Criteria:

• any condition (other than CHF) that could limit the use of prednisone;
• acute decompensated heart failure
• active myocarditis
• obstructive or restrictive cardiomyopathy
• cardiac surgery within previous 3 months
• acute coronary syndrome