Zymliński R, et al. - In 284 consecutive acute heart failure (AHF) patients, researchers analyzed clinical consequences of an interplay between dysfunction/injury of different end-organs, with early (within first 48 h) in-hospital worsening of heart failure and 1-year all-cause mortality taken as the primary endpoints. The presence of cardiac, kidney, liver dysfunction/injury were reported in 38%, 50%, and 54% of patients, respectively, on admission. They observed the worst 1-year survival rate in patients with three organ dysfunction/injury [46%; hazard ratio (HR) with 95% confidence interval (CI) vs patients without organ dysfunction: 6.75 (2.52–18.13), those with two (67%; HR 3.54, 95% CI 1.38–9.08), one (84%; HR 1.58, 95% CI 0.58–4.30), or no organ dysfunction/injury (90%); P < 0.01]. Compared to those with one or no organ dysfunction/injury, more frequent occurrence of heart failure worsening was seen in patients with three and two organ dysfunction/injury. Detection of those at the highest risk of poor outcomes was enabled by dysfunction/injury of > 1 end-organ dysfunction/injury.