Data from two key randomized trials of patients hospitalized with HF, the DOSE-HF (Diuretic Optimization Strategy Evaluation in Acute Decompensated Heart Failure) trial and the CARRESS-HF (Cardiorenal Rescue Study in Acute Decompensated Heart Failure) trial conducted within the NHLBI HF network, have clarified the relationship between decongestion and the risk of HF readmissions.  In these trials, 48% of the patients remained congested at the time of discharge, and predictably those patients had higher rates of readmission.^[4]  But even among the 52% of patients who left the hospital in a clinically decongested state, about two-thirds of those patients developed recurrent congestion by 60 days of follow-up.

These data highlight that not only is congestion an important target within the hospital for optimal management of patients, but that longitudinal monitoring of patients for recurrence of congestion in early post-discharge interval may be a critical target for improving clinical outcomes.