Acute exacerbation of chronic heart failure (AECHF)represents an important health problem and economic burden in recentmedicine. Despite increasing interest in noninvasive tools for diagnosisand monitoring of therapy in AECHF, its reliability is still debatable. Aim of the study is to investigate the validity of inferior venacava (IVC) dynamics as a noninvasive diagnostic and monitoring tool inpatients with AECHF.Thirty patients with exacerbated HF16 males and 14 females with mean age 50 ±13 years were included. Allwere in NYHA class and Killip class III-IV and had the clinical criteria ofAECHF. All were admitted to ICU and subjected to echcardiographicstudy and estimation of urinary albumin excretion (UAE) on admission,on days 5 and 10 of treatment. Echcardiographic examination includes :a-Parameters of left ventricular dimnensions and function (PLV).b- IVC-dynamics which include , measurements of IVC diameter at endexpiration (D-max), at end inspiration (D-min) and collapse index (CI %).CI % calculated as D-max – D-min / D-max × 100 % .Significant improvement in clinical , PLV and decrease inUAE were observed. Significant decrease in D-min and D-max on day 5and 10 of treatment. IVC-CI % increased from 11.7 ± 4.8% on admissionto 27.7 ± 8.7 % and 47.2 ±8.6 % (P < 0.001) on day 5 and 10 respectivelySignificant correlations were found between the change in PLV, UAEand IVC-dynamics.Estimation of IVC-dynamics seems to be a reliableand reproducible noninvasive diagnostic and hemodynamic monitoringtool in management of AECHF.