ArticleESC heart failure2026
Non-invasive quantification of haemodynamic imbalance in acute heart failure.
Article in ESC heart failure, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
1 author.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
aimsAcute heart failure (AHF) is commonly regarded as a worsening stage of chronic heart failure (CHF), yet the haemodynamic transition to decompensation remains incompletely defined. This study evaluated whether a non-invasive physiology-guided approach based on venous return (VR)-cardiac output (CO) balance can provide a framework to characterize transitional circulatory states preceding overt AHF.
methodsA total of 193 patients with chronic heart failure, hypertensive heart disease, or AHF were analysed. Mean circulatory filling pressure and right atrial pressure were estimated non-invasively using inferior vena cava diameter indexed to body surface area and extracellular-to-total body water ratio, respectively. VR-CO imbalance was quantified using a composite mismatch index.
resultsThe distribution of VR-CO mismatch demonstrated a bimodal pattern on Gaussian mixture modelling, with two components (means ± SD: 2.25 ± .96 and 5.25 ± 2.61). All overt AHF cases were localized within the higher-mismatch component. Intermediate states exhibited increasing mismatch while maintaining relatively preserved forward flow, consistent with buffered circulatory states. A subset of patients exhibited marked haemodynamic mismatch without clinical congestion, representing a highly buffered pre-decompensated state.
conclusionsAHF may represent a failure of circulatory compensation in which venous return loading exceeds the capacity of forward flow. A non-invasive VR-CO framework reveals a continuum from compensated to buffered to overtly decompensated states and identifies a previously unrecognized highly buffered state preceding clinical deterioration. This physiology-guided approach may enable earlier detection of circulatory instability and provide a quantitative framework for risk stratification and therapeutic monitoring.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.