Heart failure (HF) is a progressive condition with a clinical picture resulting from reduced cardiac output (CO) and/or elevated left ventricular (LV) filling pressures (LVFP). The original Diamond-Forrester classification, based on haemodynamic data reflecting CO and pulmonary congestion, was introduced to grade severity, manage, and risk stratify advanced HF patients, providing evidence that survival progressively worsened for those classified as warm/dry, cold/dry, warm/wet, and cold/wet. Invasive haemodynamic evaluation in critically ill patients has been replaced by non-invasive haemodynamic phenotype profiling using echocardiography. Decreased CO is not infrequent among ambulatory HF patients with reduced ejection fraction, ranging from 23 to 45%. The Diamond-Forrester classification may be used in combination with the evaluation of natriuretic peptides (NPs) in ambulatory HF patients to pursue the goal of early identification of those at high risk of adverse events and personalise therapy to antagonise neurohormonal systems, reduce congestion, and preserve tissue/renal perfusion. The most benefit of the Guideline-directed medical treatment is to be expected in stable patients with the warm/dry profile, who more often respond with LV reverse remodelling, while more selective individualised treatments guided by echocardiography and NPs are necessary for patients with persisting congestion and/or tissue/renal hypoperfusion (cold/dry, warm/wet, and cold/wet phenotypes) to achieve stabilization and to avoid further neurohormonal activation, as a result of inappropriate use of vasodilating or negative chronotropic drugs, thus pursuing the therapeutic objectives. Therefore, tracking the haemodynamic status over time by clinical, imaging, and laboratory indicators helps implement therapy by individualising drug regimens and interventions according to patients' phenotypes even in an ambulatory setting.

心力衰竭 (HF) 是一种进行性疾病，临床表现为心输出量 (CO) 减少和/或左心室 (LV) 充盈压 (LVFP) 升高。最初的 Diamond-Forrester 分类基于反映 CO 和肺充血的血流动力学数据，用于对晚期心力衰竭患者进行严重程度分级、管理和风险分层，提供证据表明，那些被分类为温暖/干燥、寒冷/干燥、暖/湿，冷/湿。危重患者的有创血流动力学评估已被超声心动图的无创血流动力学表型分析所取代。在射血分数降低（23% 至 45%）的动态心力衰竭患者中，CO 降低的情况并不少见。Diamond-Forrester 分类可与动态心力衰竭患者的利尿钠肽 (NP) 评估结合使用，以实现早期识别不良事件高风险患者的目标，并进行个性化治疗，以拮抗神经激素系统、减少充血和缓解心力衰竭。保留组织/肾脏灌注。指南指导的医疗治疗的最大益处预计适用于具有温暖/干燥特征的稳定患者，他们更常通过左心室逆重塑做出反应，而对于持续充血的患者，则需要超声心动图和 NP 指导下更具选择性的个体化治疗和/或组织/肾脏灌注不足（冷/干、温/湿和冷/湿表型），以实现稳定并避免因不恰当使用血管舒张药物或负性变时药物而导致进一步的神经激素激活，从而实现治疗目标。因此，通过临床、影像和实验室指标跟踪一段时间内的血流动力学状态，即使在门诊环境中，也有助于根据患者的表型个体化药物治疗方案和干预措施来实施治疗。