1. Evaluation of the role of serum urocortin 2 levels in acute decompensated HF patients and their association with clinical and echocardiographic findings.
2. Assessment of the clinical utility of urocortin 2 in monitoring AHF patients.
3. Comparison between urocortin 2 and BNP as a biomarker in AHF patients

Heart failure (HF) is a clinical syndrome with symptoms and/or signs caused by a structural and/ or functional cardiac abnormality and corroborated by elevated natriuretic peptide levels and/or objective evidence of pulmonary or systemic congestion. (1) .The pathophysiology of HF is a complex interplay of genetic and multiple molecular mechanisms (from inflammation to hormonal pathways) performing in the composite network of the cardiovascular system environment. (2).

Monitoring of biomarkers in HF can be used to make an initial diagnosis, to aid in prognostic stratification, and to identify a patient's response to therapeutic intervention. (3).

Natriuretic peptide (NP) concentrations are quantitative plasma biomarkers for the presence and severity of haemo-dynamic cardiac stress and heart failure. (4). That facilitate renal filtration and sodium excretion whilst suppressing the vasoconstrictor sodium, retaining Renin angiotensin aldosterone system and exerting a tonic anti-trophic effect. (5). But the natriuretic peptide levels are significantly affected by weight, the NT- proBNP in obese subjects is much lower than normal weight subjects. (6). Other factors that affect BNP levels including gender, age and renal disease

Inclusion Criteria:

• Adult patients with acute decompensated heart failure.

Exclusion Criteria:

• Acute coronary syndrome or stroke in the past 3 months.
• Severe chronic kidney disease.
• Severe valve disease.

both gender above 18 years old with acute decompensated heart failure without ACS or stroke in the past 3 months or severe valvular disease or severe CKD .