Acute Heart Failure: From Initial Clinical Management to Hospital Discharge

Dear All,

Acute heart failure (AHF) is an increasingly common public health problem with considerable morbidity and mortality. AHF syndromes have a broad clinical spectrum with different prognoses and therapeutic implications. Management should primarily address restoration of adequate perfusion, oxygen exchanges, and effective decongestion. Today, we can take advantage of various drugs, interventions, and devices according to the patient's clinical profile, the etiology of the disease, and comorbidities.

Nevertheless, what we have and know is only sometimes combined in proper clinical decision-making and tailored therapeutic approaches. We decided to write this dedicated issue for ourselves and all healthcare providers willing to focus on the state-of-the-art clinical management of AHF.

We did our best to provide practical tools to navigate from the time of hospitalization to discharge, including:

- Definition and classification of patient phenotypes;

- Risk stratification in the Emergency Department;

- Clinical and ultrasonographic assessment of congestion and fluid status;

- Tailored approach and treatment according to patient phenotype, heart disease, and comorbidities;

- Escalation and de-escalation of care in acute heart failure syndromes, particularly in high-risk patients (e.g., cardiogenic shock);

- The role of invasive hemodynamic monitoring in acute heart failure and cardiogenic shock;

- The role of biomarkers in monitoring patients with acute heart failure;

- Current strategies for congestion relief and or to improve end-organ perfusion;

- Transition from the acute phase to implementation and up-titration of guideline-directed medical therapy;

- The role of transcatheter interventions and or device therapy in heart failure;

- Potential impact of novel drugs;

- Identification of patients with a high risk of readmission—particularly those with residual congestion—at hospital discharge and treatments that may reduce the incidence of adverse clinical outcomes.

Dr. Marco Marini
Dr. Francesco Orso
Prof. Dr. Francesco Grigioni
Guest Editors

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• Acute heart failure
• Clinical profiles
• Congestion
• Perfusion
• Guidelines-directed medical therapy
• Risk stratification