Selvaraj S, Claggett B, Pozzi A, et al. - Since no information is available about the modern prognostic significance of the physical examination, beyond traditional risk factors, in heart failure with reduced ejection fraction (HFrEF), researchers undertook this investigation in participants from PARADIGM-HF (Prospective Comparison of Angiotensin Receptor-Neprilysin Inhibitor With Angiotensin Converting Enzyme Inhibitor to Determine Impact on Global Mortality and Morbidity in HF) in order to examine the link between physical signs of congestion at baseline and during study follow up with quality of life (QoL) and clinical results. They focused on the therapeutic impacts of sacubitril/valsartan on congestion. They found significant, independent prognostic value of the physical exam in HFrEF that was even beyond symptoms, natriuretic peptides, and Meta-Analysis Global Group in Chronic Heart Failure risk score. Compared with enalapril, a greater extent of improvement in congestion was brought about by sacubitril/valsartan. Findings revealed an independent link between reducing congestion in the outpatient setting and improved QoL and attenuated cardiovascular events, including mortality.