Javaloyes P, et al. - Researchers examined patients with acute heart failure (AHF) to compare the clinical features and outcomes according to clinical profiles based on congestion and perfusion determined in the emergency department (ED). Among 11,261 unselected AHF patients, four phenotypes were defined: warm + wet (n=8558, 76.0%), cold + wet (n=1929, 17.1%), warm + dry (n=675, 6.0%), and cold + dry (n=99, 0.9%). One-year mortality of 30.8% was reported, and significantly increased adjusted hazard ratios were reported for cold + wet and cold + dry, compared to warm + dry. As for index episode hospitalisation and in-hospital mortality, higher rates were seen in hypoperfused (cold) phenotypes, while a higher risk of prolonged hospitalisation but reduced risk of rehospitalisation was observed in congestive (wet) phenotypes. Overall, useful complementary information can be obtained and patient outcomes soon after ED patient arrival could be predicted by bedside clinical assessment of congestion and perfusion of AHF patients upon ED arrival as well as organization according to phenotypic profiles suggested by the latest European Society of Cardiology guidelines.