Key result
HF congestion drives systemic multi-organ dysfunction and requires multidisciplinary management to improve survival.
Why the study?
Congestion in HF is traditionally viewed as hemodynamic, but is increasingly recognized as a systemic process affecting multiple organs that requires comprehensive management.
Effective management of heart failure congestion requires a multidisciplinary approach addressing its systemic, multisystem pathophysiology.
Systemic congestion in HF warrants multiorgan assessment; leaves open targeted therapies for prospective validation.
Congestion is a key clinical feature of heart failure (HF), contributing to hospitalizations, disease progression, and poor outcomes. While traditionally considered a hemodynamic issue, congestion is now recognized as a systemic process affecting multiple organs. Renal dysfunction arises from impaired perfusion and sodium retention, leading to maladaptive left ventricular remodeling. Hepatic congestion contributes to cholestatic liver injury, while metabolic disturbances drive anemia, muscle wasting, and systemic inflammation. Additionally, congestion disrupts the intestinal barrier and immune function, exacerbating HF progression. Given its widespread impact, effective congestion management requires a shift from a cardiovascular-centered approach to a comprehensive, multidisciplinary strategy. Targeted decongestive therapy, metabolic and nutritional optimization, and immune modulation are crucial in mitigating congestion-related organ dysfunction. Early recognition and intervention are essential to slow disease progression, preserve functional capacity, and improve survival. Addressing HF congestion through personalized, evidence-based strategies is vital for optimizing long-term care and advancing treatment paradigms.
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Mocan et al. (2025) conducted a review in Heart failure. Congestion was evaluated. Congestion in heart failure is a systemic process affecting multiple organs, requiring a comprehensive, multidisciplinary management strategy to mitigate organ dysfunction and improve survival.
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