System Maintenance Notice

Please note that maintenance work is scheduled between 4 AM and 5 AM - CET. During this time, you may experience reduced performance. Thanks for your patience.

Publications

Journal Article Review Epublish 1 citation

PubMed: 40278183 DOI: 10.3390/jcdd12040124

Unveiling the Systemic Impact of Congestion in Heart Failure: A Narrative Review of Multisystem Pathophysiology and Clinical Implications.

J Cardiovasc Dev Dis 12(4)

Authors: Daniela Mocan, Radu Jipa, Daniel Alexandru Jipa, Radu Ioan Lala, Florin Claudiu Rasinar, Iulia Groza, Ronela Sabau, Damaris Sulea Bratu, Diana Federica Balta, Sergiu Teodor Cioban, Maria Puschita

Affiliations

  • Multidisciplinary Doctoral School, Vasile Goldis Western University of Arad, 310025 Arad, Romania. Research Center of the Institute of Cardiovascular Diseases Timisoara, 300310 Timisoara, Romania. Department VII, Internal Medicine II, Discipline of Cardiology, University of Medicine and Pharmacy "Victor Babes" Timisoara, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania. Institute of Cardiovascular Diseases of Timisoara, 300310 Timisoara, Romania.
  • Faculty of Medicine, Department of "Life Sciences", Vasile Goldis Western University of Arad, Romania 86, Liviu Rebreanu Street, 310048 Arad, Romania.
  • Arad County Clinical Emergency Hospital, 310037 Arad, Romania.
  • Doctoral School, Victor Babes University of Timisoara, 300041 Timisoara, Romania.
  • Victor Babes Clinical Hospital for Infectious Diseases and Pneumology of Timisoara, 300041 Timisoara, Romania.
  • Multidisciplinary Doctoral School, Vasile Goldis Western University of Arad, 310025 Arad, Romania.
  • Research Center of the Institute of Cardiovascular Diseases Timisoara, 300310 Timisoara, Romania. Department VII, Internal Medicine II, Discipline of Cardiology, University of Medicine and Pharmacy "Victor Babes" Timisoara, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania. Institute of Cardiovascular Diseases of Timisoara, 300310 Timisoara, Romania. Doctoral School, Victor Babes University of Timisoara, 300041 Timisoara, Romania.
  • Arad County Clinical Emergency Hospital, 310037 Arad, Romania. Doctoral School, Victor Babes University of Timisoara, 300041 Timisoara, Romania.

Abstract

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.

MeSH

Heart Failure, Heart, Disease Progression, Therapeutics

Cited by