Background: The GALACTIC TRIAL (Goal Directed Afterload Reduction in Acute Congestive Cardiac Decompensation Study) is a prospective, randomized, interventional controlled trial. Designed to determine whether an early goal-directed decrement of preload and afterload with a target systolic blood pressure of 90-110 mmHg by aggressive vasodilatation in patients with acute HF in the non-ICU setting is safe, and leads to a better clinical and economical outcome. Trial Registration No: NCT00512759 (clinicaltrials.gov) Link Trial Status: finished, results submitted Enrolling Centers: Switzerland Worldwide: University Hospital Basel Brazil: University of Sao Paulo Cantonal Hospital Aarau (Enrollment finished) Spain: Hospital de la Santa Creu i Sant Pau Cantonal Hospital Luzern (Enrollment finished) Hospital Germans Trias i Pujo Hospital St. Gallen Germany: Klinikum Nürnberg Nord (Enrollm. finished) Klinikum Mainz Bulgaria: Sofia, University Hospital Tsaritsa Yoanna-Isul, 5th Multifunctional Hospital Core Study Team: