{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T22:34:39Z","timestamp":1773182079177,"version":"3.50.1"},"reference-count":25,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T00:00:00Z","timestamp":1768780800000},"content-version":"vor","delay-in-days":3029,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2017,10,4]],"date-time":"2017-10-04T00:00:00Z","timestamp":1507075200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2017,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Although loop diuretics are the most commonly used drugs in acute heart failure (AHF) treatment, their short-term and long-term effects are relatively unknown. The significance of worsening renal function occurrence during intravenous treatment is not clear enough. This trial aims to clarify all these features and contemplate whether continuous infusion is better than an intermittent strategy in terms of decongestion efficacy, diuretic efficiency, renal function, and long-term prognosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>This is a prospective, multicentre, randomized study that compares continuous infusion to intermittent infusion and a low vs. high diuretic dose of furosemide in patients with a diagnosis of acute heart failure, BNP \u2265 100 pg\/mL, and specific chest X-ray signs. Randomization criteria have been established at a 1:1 ratio using a computer-generated scheme of either twice-daily bolus injection or continuous infusion for a time period ranging from 72 to 120 h. The initial dose will be 80 mg\/day of intravenous furosemide and, in the case of poor response, will be doubled using an escalation algorithm. A high diuretic dose is defined as a furosemide daily amount &amp;gt;120 mg\/day respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Continuous and high dose groups could reveal a more intensive diuresis and a greater decongestion with respect to intermittent and low dose groups; high dose and poor loop diuretic efficiency should be related to increased diuretic resistance, renal dysfunction occurrence, and greater congestion status. Poor diuretic response will be associated with less decongestion and an adverse prognosis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ehf2.12226","type":"journal-article","created":{"date-parts":[[2017,10,5]],"date-time":"2017-10-05T00:08:43Z","timestamp":1507162123000},"page":"479-486","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Rationale and Study Design of Intravenous Loop Diuretic Administration in Acute Heart Failure: DIUR-AHF"],"prefix":"10.1093","volume":"4","author":[{"given":"Alberto","family":"Palazzuoli","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Cardiovascular Diseases Unit, S. Maria alle Scotte Hospital, University of Siena , Siena ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gaetano","family":"Ruocco","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Cardiovascular Diseases Unit, S. Maria alle Scotte Hospital, University of Siena , Siena ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giorgio","family":"Vescovo","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Hospital S.Antonio , Padua ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roberto","family":"Valle","sequence":"additional","affiliation":[{"name":"Cardiology Department, Chioggia Hospital , Chioggia ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Salvatore","family":"Di Somma","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, University of Roma, Sant'Andrea Hospital , Rome ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ranuccio","family":"Nuti","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Cardiovascular Diseases Unit, S. Maria alle Scotte Hospital, University of Siena , Siena ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2017,10,4]]},"reference":[{"key":"2026012115150786100_ehf212226-bib-0001","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1016\/j.ijcard.2007.05.032","article-title":"A propensity matched study of the effects of chronic diuretic therapy on mortality and hospitalization in older adults with heart failure","volume":"125","author":"Ahmed","year":"2008","journal-title":"Int J Cardiol"},{"key":"2026012115150786100_ehf212226-bib-0002","doi-asserted-by":"crossref","first-page":"797","DOI":"10.1056\/NEJMoa1005419","article-title":"Diuretic strategies in acute decompensated heart failure","volume":"364","author":"Felker","year":"2011","journal-title":"N Engl J Med"},{"key":"2026012115150786100_ehf212226-bib-0003","first-page":"CD003178","article-title":"Continuous infusion versus bolus injection of loop diuretics in congestive heart failure","volume":"3","author":"Salvador","year":"2005","journal-title":"Cochrane Database Syst Rev"},{"key":"2026012115150786100_ehf212226-bib-0004","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1016\/j.ahj.2015.05.003","article-title":"Diuretic response in acute heart failure\u2014an analysis from ASCEND-HF","volume":"170","author":"Ter Maaten","year":"2015","journal-title":"Am Heart J"},{"key":"2026012115150786100_ehf212226-bib-0005","doi-asserted-by":"crossref","first-page":"1230","DOI":"10.1002\/ejhf.170","article-title":"RELAX-AHF Investigators. 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