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Figure 1 Schematic for assessment of clinical profiles. Congestion was assessed by the presence of orthopnea, jugular venous distention, rales, hepatojugular reflux, ascites, peripheral edema, leftward radiation of the pulmonic heart sound, or a square-wave blood pressure response to the Valsalva maneuver. Compromised perfusion was assessed by the presence of a narrow proportional pulse pressure, pulsus alternans, symptomatic hypotension (without orthostasis), cool extremities, and/or impaired mentation.