Heart failure is a special clinical syndrome such as difficulty breathing, fatigue, and swollen legs characterized by increased JVP, crackle lung sounds, and peripheral edema caused by heart disorders both structural and/or functional, resulting in decreased cardiac output and increased intracardiac pressure at rest and activity. Body positioning has been shown to affect stroke volume and parasympathetic modulating activity. The right lateral 30" semifowler position is a very safe position in heart failure patients admitted to the ICU. Although body positioning can affect stroke volume, and parasympathetic modulation, it is not yet clear what effect it has on cardiac output

Inclusion Criteria:

• The patient was diagnosed with acute decompensated heart failure,
• fully conscious,
• not intubated,
• >18 years old,
• had no mobility problems,
• palpable radial artery pulsation,
• was not under the influence of anti-hypotensive drugs,
• willing to be a respondent,
• LVEF <50%.

Exclusion Criteria:

• Pulmonary edema,
• severe valve disease comorbidities,
• receiving high doses of anti-hypotensive treatment,
• heart failure readmission in the last 3 months,
• finger edema,
• use of mechanical circulatory support,
• irregular rhythms,
• artificial pacemaker attached,
• obesity
• peripheral perfusion disorders
• cardiogenic shock