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Background: Heart failure is a growing problem worldwide with high degree of morbidity and mortality especially in those with dilated cardiomyopathy. We hypothesized that noninvasive bi level positive airway pressure ventilation (BIPAP) could play a crucial role in those patients.Aim of Study: To study the effect of Non Invasive bi-level positive air way pressure (BIPAP) ventilation on the clinical, hemodynamic parameters in patients with heart failure NYHA class 3-4 due to dilated cardiomyopathy.Patients and Methods: Forty adult patients, (18-83 years old) of both sex with decompensated heart failure and dilated cardiomyopathy (LVEF |