 The potential utility of USCOM for assessing patients with adHF has recently been suggested. Inotropy measurements derived from USCOM are greatly reduced in patients with New York Heart Association NYHA Class IV and American Heart association AHA stage C, acute left ventricular failure, when compared with healthy controls. These findings have led to the proposal that as USCOM can measure inotropy, then it could be used to assess and to manage heart failure. Although inotropy, derived by USCOM, is low in patients with adHF and NYHA class IV, nevertheless there is no evidence of a dose-relationship between USCOM-derived inotropy and NYHA class, or of a correlation with increasing severity of adHF, with ejection fraction. 