Signs and symptoms of fluid overload are the primary reason for hospital admission of patients with acute decompensated heart failure. It has been shown that congestion is a dynamic state with mutual links to both heart failure and renal dysfunction, which is capable of modifying the impact of these two elements on the outcomes. In this article, we provide an overview of the emerging concepts related to pathophysiological aspects of fluid overload in heart failure. Then, methods for objective evaluation of congestion are discussed with emphasis on newer techniques Future studies are needed to determine whether more precise evaluation of fluid overload combined with close monitoring of decongestion process would have a salutary impact on the outcomes of patients with heart failure.
Negiin Pourafshar, Ashkan Karimi and Amir Kazory