Editorial: Role of congestion in heart failure: From bench to clinical practice

Congestion plays a central role in the pathophysiology of heart failure (HF) and remains a clinical challenge to detect, prevent, and treat it effectively. Residual fluid overload at the time of discharge, which is frequently underdiagnosed, is one of the main risk factors for readmission (Lala et al., 2015; Rivas-Lasarte et al., 2020). To date, congestion is evaluated through clinical history, physical examination, determination of plasma natriuretic peptide, and X-Ray. However, emerging tools such as ultrasound imaging, remote dielectric sensing technology (ReDS), and new biomarkers such CA 12.5 offer an earlier and more accurate diagnosis. In addition, some of the new drugs for the treatment of HF, such as sacubitril-valsartan or type 2 sodium-glucose cotransporter inhibitors (SGLT2i), have a diuretic effect and the weight of this peculiarity on prognosis has yet to be elucidated. The aim of this Research Topic on the “Role of Congestion in Heart Failure: From Bench to Clinical Practice” is to summarize knowledge on the precise mechanisms involved in the development of congestion in HF, new techniques to assess fluid overload, and to discuss current and emerging treatment approaches to relieve congestion and, ultimately, impact prognosis. The eight original articles included cover a range of Research Topic, from cutting-edge research findings in animal models to the novel tools and treatments used in daily clinical practice. Han et al. reinforce the prognostic impact of congestive HF exerts on survival in nearly 70,000 patients from Singapore undergoing surgery. Making use of several statistical models they indistinctly observe that congestive HF is an independent risk factor for 1-year mortality after surgery, underscoring the need for optimizing clinical decision-making, improving preoperative consultation, and promoting clinical communication. Three original articles in the Research Topic discuss the role of ultrasound imaging techniques, underlining the emerging prognostic role of lung ultrasound in different clinical OPEN ACCESS