{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T13:25:17Z","timestamp":1783430717092,"version":"3.54.6"},"reference-count":19,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2025,12,20]],"date-time":"2025-12-20T00:00:00Z","timestamp":1766188800000},"content-version":"vor","delay-in-days":1662,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2021,6,2]],"date-time":"2021-06-02T00:00:00Z","timestamp":1622592000000},"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":[[2021,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Heart failure with reduced ejection fraction (HFrEF) and heart failure with preserved ejection fraction (HFpEF) had distinct haemodynamic characteristics in the setting of acute heart failure. The aim of our study is to evaluate the differential response to aggressive diuresis in HFrEF and HFpEF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>Patients in the Diuretic Optimization Strategies Evaluation trial with left ventricular ejection fraction measurement were included (n = 300) and classified into HFrEF [left ventricular ejection fraction (LVEF) &amp;lt; 40%] (n = 193) and HFpEF (LVEF \u2265 40%) (n = 107). Effect of high-dose vs. low-dose furosemide strategy was compared separately in HFrEF and HFpEF. In HFrEF, high-dose strategy did not increase change in creatinine or cystatin C at 72 h [treatment difference: \u22120.05, 95% confidence interval (CI): \u22120.14 to 0.03 mg\/dL; P = 0.23 for creatinine, and treatment difference: \u22120.06, 95% CI: \u22120.15 to 0.02 mg\/dL; P = 0.15 for cystatin C] compared with low-dose strategy, but there were significantly more net fluid loss, weight loss, and congestion-free patients at 72 h in high-dose group. It was also associated with a significantly lower risk of composite clinical outcome of death, total hospitalizations, and unscheduled visits due to heart failure. In HFpEF, high-dose strategy significantly increased change in creatinine and cystatin C at 72 h (treatment difference: 0.16; 95% CI: 0.02\u20130.30 mg\/dL; P = 0.03 for creatinine, and treatment difference: 0.26; 95% CI: 0.09\u20130.43 mg\/dL; P = 0.003 for cystatin C), but did not significantly affect net fluid loss, weight loss, proportion of congestion-free patients at 72 h, and risk of the composite clinical outcome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Acute heart failure on the basis of HFrEF and HFpEF responded differently to aggressive diuresis. Future trials should be designed separately for HFrEF and HFpEF.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ehf2.13453","type":"journal-article","created":{"date-parts":[[2021,6,2]],"date-time":"2021-06-02T12:51:36Z","timestamp":1622638296000},"page":"3248-3256","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Effect of Aggressive Diuresis in Acute Heart Failure with Reduced and Preserved Ejection Fraction"],"prefix":"10.1093","volume":"8","author":[{"given":"Xin","family":"He","sequence":"first","affiliation":[{"name":"Department of Cardiology, the First Affiliated Hospital of Sun Yat-sen University , 58 Zhongshan 2nd Road, Guangzhou, 510080 ,","place":["China"]},{"name":"NHC Key Laboratory of Assisted Circulation (Sun Yat-sen University) , Guangzhou ,","place":["China"]},{"name":"National - Guangdong Joint Engineering Laboratory for Diagnosis and Treatment of Vascular Diseases , Guangzhou ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bin","family":"Dong","sequence":"additional","affiliation":[{"name":"Department of Cardiology, the First Affiliated Hospital of Sun Yat-sen University , 58 Zhongshan 2nd Road, Guangzhou, 510080 ,","place":["China"]},{"name":"NHC Key Laboratory of Assisted Circulation (Sun Yat-sen University) , Guangzhou ,","place":["China"]},{"name":"National - Guangdong Joint Engineering Laboratory for Diagnosis and Treatment of Vascular Diseases , Guangzhou ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruicong","family":"Xue","sequence":"additional","affiliation":[{"name":"Department of Cardiology, the First Affiliated Hospital of Sun Yat-sen University , 58 Zhongshan 2nd Road, Guangzhou, 510080 ,","place":["China"]},{"name":"NHC Key Laboratory of Assisted Circulation (Sun Yat-sen University) , Guangzhou ,","place":["China"]},{"name":"National - Guangdong Joint Engineering Laboratory for Diagnosis and Treatment of Vascular Diseases , Guangzhou ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingjing","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Cardiology, the First Affiliated Hospital of Sun Yat-sen University , 58 Zhongshan 2nd Road, Guangzhou, 510080 ,","place":["China"]},{"name":"NHC Key Laboratory of Assisted Circulation (Sun Yat-sen University) , Guangzhou ,","place":["China"]},{"name":"National - Guangdong Joint Engineering Laboratory for Diagnosis and Treatment of Vascular Diseases , Guangzhou ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zexuan","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, the First Affiliated Hospital of Sun Yat-sen University , 58 Zhongshan 2nd Road, Guangzhou, 510080 ,","place":["China"]},{"name":"NHC Key Laboratory of Assisted Circulation (Sun Yat-sen University) , Guangzhou ,","place":["China"]},{"name":"National - Guangdong Joint Engineering Laboratory for Diagnosis and Treatment of Vascular Diseases , Guangzhou ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuzhong","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, the First Affiliated Hospital of Sun Yat-sen University , 58 Zhongshan 2nd Road, Guangzhou, 510080 ,","place":["China"]},{"name":"NHC Key Laboratory of Assisted Circulation (Sun Yat-sen University) , Guangzhou ,","place":["China"]},{"name":"National - Guangdong Joint Engineering Laboratory for Diagnosis and Treatment of Vascular Diseases , Guangzhou ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuanyuan","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Cardiology, the First Affiliated Hospital of Sun Yat-sen University , 58 Zhongshan 2nd Road, Guangzhou, 510080 ,","place":["China"]},{"name":"NHC Key Laboratory of Assisted Circulation (Sun Yat-sen University) , Guangzhou ,","place":["China"]},{"name":"National - Guangdong Joint Engineering Laboratory for Diagnosis and Treatment of Vascular Diseases , Guangzhou ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dexi","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, the First Affiliated Hospital of Sun Yat-sen University , 58 Zhongshan 2nd Road, Guangzhou, 510080 ,","place":["China"]},{"name":"NHC Key Laboratory of Assisted Circulation (Sun Yat-sen University) , Guangzhou ,","place":["China"]},{"name":"National - Guangdong Joint Engineering Laboratory for Diagnosis and Treatment of Vascular Diseases , Guangzhou ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yugang","family":"Dong","sequence":"additional","affiliation":[{"name":"Department of Cardiology, the First Affiliated Hospital of Sun Yat-sen University , 58 Zhongshan 2nd Road, Guangzhou, 510080 ,","place":["China"]},{"name":"NHC Key Laboratory of Assisted Circulation (Sun Yat-sen University) , Guangzhou ,","place":["China"]},{"name":"National - Guangdong Joint Engineering Laboratory for Diagnosis and Treatment of Vascular Diseases , Guangzhou ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiangui","family":"He","sequence":"additional","affiliation":[{"name":"Department of Cardiology, the First Affiliated Hospital of Sun Yat-sen University , 58 Zhongshan 2nd Road, Guangzhou, 510080 ,","place":["China"]},{"name":"NHC Key Laboratory of Assisted Circulation (Sun Yat-sen University) , Guangzhou ,","place":["China"]},{"name":"National - Guangdong Joint Engineering Laboratory for Diagnosis and Treatment of Vascular Diseases , Guangzhou ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chen","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, the First Affiliated Hospital of Sun Yat-sen University , 58 Zhongshan 2nd Road, Guangzhou, 510080 ,","place":["China"]},{"name":"NHC Key Laboratory of Assisted Circulation (Sun Yat-sen University) , Guangzhou ,","place":["China"]},{"name":"National - Guangdong Joint Engineering Laboratory for Diagnosis and Treatment of Vascular Diseases , Guangzhou ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,6,2]]},"reference":[{"key":"2026012114203443900_ehf213453-bib-0001","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1056\/NEJMoa052256","article-title":"Trends in prevalence and outcome of heart failure with preserved ejection fraction","volume":"355","author":"Owan","year":"2006","journal-title":"N Engl J Med"},{"key":"2026012114203443900_ehf213453-bib-0002","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1161\/CIRCRESAHA.115.302922","article-title":"Heart failure with preserved ejection fraction: mechanisms, clinical features, and therapies","volume":"115","author":"Sharma","year":"2014","journal-title":"Circ Res"},{"key":"2026012114203443900_ehf213453-bib-0003","doi-asserted-by":"crossref","first-page":"1069","DOI":"10.1016\/j.amjcard.2008.05.058","article-title":"Comparison of blood volume characteristics in anemic patients with low versus preserved left ventricular ejection fractions","volume":"102","author":"Abramov","year":"2008","journal-title":"Am J Cardiol"},{"key":"2026012114203443900_ehf213453-bib-0004","doi-asserted-by":"crossref","first-page":"442","DOI":"10.1016\/j.jacc.2011.09.062","article-title":"Effects of vasodilation in heart failure with preserved or reduced ejection fraction implications of distinct pathophysiologies on response to therapy","volume":"59","author":"Schwartzenberg","year":"2012","journal-title":"J Am Coll Cardiol"},{"key":"2026012114203443900_ehf213453-bib-0005","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1016\/j.jchf.2016.01.005","article-title":"Volume overload profiles in patients with preserved and reduced ejection fraction chronic heart failure: are there differences? A pilot study","volume":"4","author":"Miller","year":"2016","journal-title":"JACC Heart Fail"},{"key":"2026012114203443900_ehf213453-bib-0006","first-page":"331","article-title":"Relationship between heart failure treatment and development of worsening renal function among hospitalized patients","volume":"147","author":"Butler","year":"2004","journal-title":"Am Heart J"},{"key":"2026012114203443900_ehf213453-bib-0007","doi-asserted-by":"crossref","first-page":"797","DOI":"10.1056\/NEJMoa1005419","article-title":"Diuretic strategies in patients with acute decompensated heart failure","volume":"364","author":"Felker","year":"2011","journal-title":"N Engl J Med"},{"key":"2026012114203443900_ehf213453-bib-0008","doi-asserted-by":"crossref","first-page":"2533","DOI":"10.1001\/jama.2013.282190","article-title":"Low-dose dopamine or low-dose nesiritide in acute heart failure with renal dysfunction: the ROSE acute heart failure randomized trial","volume":"310","author":"Chen","year":"2013","journal-title":"JAMA"},{"key":"2026012114203443900_ehf213453-bib-0009","doi-asserted-by":"crossref","first-page":"859","DOI":"10.1016\/j.jchf.2018.04.008","article-title":"Randomized evaluation of heart failure with preserved ejection fraction patients with acute heart failure and dopamine: the ROPA-DOP trial","volume":"6","author":"Sharma","year":"2018","journal-title":"JACC Heart Fail"},{"key":"2026012114203443900_ehf213453-bib-0010","doi-asserted-by":"crossref","first-page":"570","DOI":"10.1161\/CIRCULATIONAHA.117.033065","article-title":"Comparison of time-to-first event and recurrent-event methods in randomized clinical trials","volume":"138","author":"Claggett","year":"2018","journal-title":"Circulation"},{"key":"2026012114203443900_ehf213453-bib-0011","first-page":"701","article-title":"Nonparametric inference for a family of counting processes","author":"Aalen","year":"1978","journal-title":"Ann Stat"},{"key":"2026012114203443900_ehf213453-bib-0012","doi-asserted-by":"crossref","first-page":"1065","DOI":"10.1080\/01621459.1989.10478873","article-title":"Regression analysis of multivariate incomplete failure time data by modeling marginal distributions","volume":"84","author":"Wei","year":"1989","journal-title":"J Am Stat Assoc"},{"key":"2026012114203443900_ehf213453-bib-0013","doi-asserted-by":"crossref","first-page":"E17","DOI":"10.1111\/chf.12015","article-title":"Lack of concordance in defining worsening renal function by rise in creatinine vs rise in cystatin C","volume":"19","author":"Dupont","year":"2013","journal-title":"Congest Heart Fail"},{"key":"2026012114203443900_ehf213453-bib-0014","doi-asserted-by":"crossref","DOI":"10.1161\/CIRCHEARTFAILURE.115.002593","article-title":"Differential response to low-dose dopamine or low-dose nesiritide in acute heart failure with reduced or preserved ejection fraction: results from the ROSE AHF trial (Renal Optimization Strategies Evaluation in Acute Heart Failure)","volume":"9","author":"Wan","year":"2016","journal-title":"Circ Heart Fail"},{"key":"2026012114203443900_ehf213453-bib-0015","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1161\/CIRCHEARTFAILURE.114.001734","article-title":"Effect of estimated plasma volume reduction on renal function for acute heart failure differs between patients with preserved and reduced ejection fraction","volume":"8","author":"Takei","year":"2015","journal-title":"Circ Heart Fail"},{"key":"2026012114203443900_ehf213453-bib-0016","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1016\/j.cardfail.2006.01.011","article-title":"Redefining the therapeutic objective in decompensated heart failure: hemoconcentration as a surrogate for plasma refill rate","volume":"12","author":"Boyle","year":"2006","journal-title":"J Card Fail"},{"key":"2026012114203443900_ehf213453-bib-0017","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1053\/j.ajkd.2016.08.027","article-title":"Diuretic resistance","volume":"69","author":"Hoorn","year":"2017","journal-title":"Am J Kidney Dis"},{"key":"2026012114203443900_ehf213453-bib-0018","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1007\/s10741-011-9233-7","article-title":"A re-appraisal of volume status and renal function impairment in chronic heart failure: combined effects of pre-renal failure and venous congestion on renal function","volume":"17","author":"Sinkeler","year":"2012","journal-title":"Heart Fail Rev"},{"key":"2026012114203443900_ehf213453-bib-0019","doi-asserted-by":"crossref","first-page":"2129","DOI":"10.1093\/eurheartj\/ehw128","article-title":"2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: the Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC)Developed with the special contribution of the Heart Failure Association (HFA) of the ESC","volume":"37","author":"Ponikowski","year":"2016","journal-title":"Eur Heart J"}],"container-title":["ESC Heart Failure"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ehf2.13453","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ehf2.13453","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/academic.oup.com\/eschf\/article-pdf\/8\/4\/3248\/65569920\/eschf_8_4_3248.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/eschf\/article-pdf\/8\/4\/3248\/65569920\/eschf_8_4_3248.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T19:25:04Z","timestamp":1769023504000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/eschf\/article\/8\/4\/3248\/8344152"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6,2]]},"references-count":19,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2021,6,2]]},"published-print":{"date-parts":[[2021,8,1]]}},"URL":"https:\/\/doi.org\/10.1002\/ehf2.13453","relation":{},"ISSN":["2055-5822"],"issn-type":[{"value":"2055-5822","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2021,8]]},"published":{"date-parts":[[2021,6,2]]},"assertion":[{"value":"2020-12-26","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-05-21","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-06-02","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}