For all patients randomized, therapy was tailored to the ultimate goal of discharge on an oral medical regimen to provide better relief of CHF symptoms, to reduce filling pressures and to maintain adequate perfusion. These goals were the same for both groups, but in the Usual Group therapy was adjusted according to clinical assessment alone, while in the PAC-directed group, actual measurement of hemodynamics was used to supplement clinical assessment. The oral medical regimen for discharge was designed by the attending heart failure physician based on the standard available medications of angiotensin converting enzyme inhibitors (ACEI), nitrates, hydralazine, furosemide and other diuretic agents. Intravenous diuretics were used when major diuresis was desired with subsequent change to oral diuretics at least 48 hours before discharge. Physicians could also use low dose infusions of dopamine or dobutamine to facilitate diuresis. Intravenous nitroprusside could be used in either group.