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BACKGROUND: Recent studies showed that clinical parameters other than cardiac function, such as physical function, cognitive function, mental status, social status, and quality of life, were associated with heart failure (HF) prognosis. These parameters have not been extensively investigated in large Japanese cohorts. Furthermore, novel biomarkers to predict prognosis or treatment responses are required to provide individualized medicine. To address these issues, we developed the Japanese Registry Of Acute Decompensated Heart Failure (JROADHF-NEXT).METHODS: JROADHF-NEXT is a prospective, multicenter, nationwide registry of patients hospitalized for acute decompensated HF. A total of 4016 patients were enrolled from 87 centers and blood and urine samples were collected from 3203 of these patients. The study protocol using the JROADHF-NEXT database was approved by all Kyushu University, International University of Health and Welfare and participating hospitals.RESULTS: The mean age was 72.9 ± 14.0 years and 61.4 % were male. Cardiomyopathy was the most common etiology (24.4 %). Volume overload and arrhythmia accounted for 26.3 % and 17.4 % of precipitating causes. The median follow-up period was 2.0 (1.6-2.2) years and 2-year follow-up completion rate was 88.5 % (n = 3554). The incidence rates for cardiovascular death and rehospitalization for HF were 5.2 and 16.7 per 100 person-years, respectively.CONCLUSIONS: The JROADHF-NEXT is a large-scale HF registry comprising extensive clinical variables with a biobank. This registry is anticipated to provide valuable insights and serve as a significant source of evidence for future research and clinical practice.