Heart failure & cardiomyopathies
Clinical Profiles and Prognostic Impact of Residual Intravascular and Tissue Congestion in Acute Heart Failure
Authors' conclusion
Patients with intravascular RC had better diuretic responses and shorter hospital stays than those with tissue/combined RC, but worse outcomes than decongested patients.
Study context
- Population
- Patients with acute decompensated heart failure (ADHF) and congestion at admission (PROTECT and RELAX-AHF-2 trials)580 (37%) with residual congestion
- Participants
- 1,557 patients
- Comparison
- Residual congestion phenotypes at day 7/discharge vs decongested
- Intravascularn = 260
- Combinedn = 185
- Tissuen = 135
- Primary endpoint
- All-cause mortality
- Follow-up
- 180 days
Methodological detailsindex and replication cohorts
- Index and replication cohorts
Primary result
As reported in the abstract
180-day mortality
Each group vs decongestedHazard ratio (95% CI)
Intravascular
1.69(1.15–2.49)
Tissue
2.07(1.25–3.41)
Further findings
In-hospital diuretic response, length of stay, IV loop diuretic dose · during hospitalization
- Solely intravascular residual congestion (RC): greater diuretic responses, shorter stays and lower IV loop diuretic doses vs tissue or combined
- all p < 0.05
180-day mortality, RELAX-AHF-2 substudy (replication)
- Similar findings observed
- n = 476
Original publication
Clinical Profiles and Prognostic Impact of Residual Intravascular and Tissue Congestion in Acute Heart Failure. Eur J Heart Fail. Published 11 November 2025. doi:10.
Summarised from the published abstract; every number is checked against it