Innovations in Acute Heart Failure: POCUS-Guided Diagnosis, Risk Stratification, and Emerging Therapies

Dear Colleagues,

Acute heart failure (AHF) remains a major cause of emergency hospitalizations worldwide and is associated with substantial morbidity, mortality, and healthcare costs. It is characterized by the rapid onset or worsening of symptoms such as dyspnea, congestion/fluid overload, peripheral edema, and reduced cardiac output, often triggered by ischemia, arrhythmias, uncontrolled hypertension, infection, poor adherence, or progression of underlying cardiac disease. Despite advances in chronic heart failure therapies, the acute setting continues to represent an area of unmet clinical need, with high short- and long-term mortality and frequent early readmissions.

This Special Issue aims to provide an up-to-date and clinically relevant overview of contemporary strategies for AHF prevention, early recognition, and treatment, emphasizing precision phenotyping, early risk stratification, and individualized management across the entire patient journey (emergency department, inpatient care, and post-discharge follow-up). Topics of interest include clinical phenotypes of AHF (including de novo versus decompensated chronic HF, HfpEF, and HFrEF presentations), precipitating factors, and the integration of biomarkers (NT-proBNP, troponins and emerging markers) and imaging into diagnostic algorithms. In particular, point-of-care ultrasound (POCUS) and bedside echocardiography are highlighted as valuable tools for rapid assessment of volume status, pulmonary congestion, ventricular function, and hemodynamics, supporting decision-making in time-critical settings.

Therapeutic areas of interest include decongestion strategies (loop diuretics, combination diuretic therapy, and ultrafiltration), vasodilators, and inotropes, as well as modern neurohormonal therapies and novel agents (e.g., SGLT2 inhibitors and angiotensin receptor–neprilysin inhibitors) and their optimal timing in acute care. Dedicated attention will be given to advanced AHF presentations such as cardiogenic shock, refractory congestion, cardiorenal interactions, and the use of hemodynamic monitoring and mechanical circulatory support where appropriate.

Importantly, this Issue also welcomes contributions on special categories of heart failure and cardiomyopathies that require targeted diagnostic approaches and disease-specific therapies, including cardiac amyloidosis and other restrictive phenotypes. Furthermore, inherited cardiomyopathies represent a critical area where genetic testing, genetic counseling, and family-based medicine play a central role in diagnosis, risk stratification, cascade screening, and personalized management.

We invite original research articles, systematic reviews, meta-analyses, and expert perspectives addressing AHF epidemiology, pathophysiology, clinical trials, real-world outcomes, implementation science, telemedicine-based monitoring, transitional care pathways, and interventions aimed at reducing recurrences and improving patient outcomes.

Dr. Maria Marketou
Guest Editors

Dr. Anthoula Plevritaki
Guest Editor Assistant

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• acute heart failure
• point-of-care ultrasound (POCUS)
• cardiogenic shock
• decongestion therapy
• biomarker-guided treatment
• SGLT2 inhibitors
• HFpEF
• cardiac remodeling
• telemedicine
• cardiac amyloidosis
• inherited cardiomyopathies