The GUIDE-HF team1 should be congratulated on attempting to master congestion, a key driver of symptoms, signs, and progression heart failure. Controlling congestion is associated with an excellent prognosis,2 consideration for new universal definition failure.3 Symptoms signs are late, subjective, insensitive measures compared blood biomarkers, ultrasound, haemodynamics.3,4 Raised (>15 mm Hg) ...