{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T10:40:40Z","timestamp":1790073640655,"version":"4.0.1"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2025,10,15]],"date-time":"2025-10-15T00:00:00Z","timestamp":1760486400000},"content-version":"vor","delay-in-days":602,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2024,2,21]],"date-time":"2024-02-21T00:00:00Z","timestamp":1708473600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"publisher","award":["PI20\/00689"],"award-info":[{"award-number":["PI20\/00689"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"publisher","award":["PI20\/00689"],"award-info":[{"award-number":["PI20\/00689"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,6,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Hypertonic saline solution (HSS) plus intravenous (IV) loop diuretic appears to enhance the diuretic response in patients hospitalized for heart failure (HF). The efficacy and safety of this therapy in the ambulatory setting have not been evaluated. We aimed to describe the design and baseline characteristics of the SALT-HF trial participants.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>\u2018Efficacy of Saline Hypertonic Therapy in Ambulatory Patients with HF\u2019 (SALT-HF) trial was a multicenter, double-blinded, and randomized study involving ambulatory patients who experienced worsening heart failure (WHF) without criteria for hospitalization. Enrolled patients had to present at least two signs of volume overload, use \u2265 80 mg of oral furosemide daily, and have elevated natriuretic peptides. Patients were randomized 1:1 to treatment with a 1-h infusion of IV furosemide plus HSS (2.6\u20133.4% NaCl depending on plasmatic sodium levels) versus a 1-h infusion of IV furosemide at the same dose (125\u2013250 mg, depending on basal loop diuretic dose). Clinical, laboratory, and imaging parameters were collected at baseline and after 7 days, and a telephone visit was planned after 30 days. The primary endpoint was 3-h diuresis after treatment started. Secondary endpoints included (a) 7-day changes in congestion data, (b) 7-day changes in kidney function and electrolytes, (c) 30-day clinical events (need of IV diuretic, HF hospitalization, cardiovascular mortality, all-cause mortality or HF-hospitalization).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 167 participants [median age, 81 years; interquartile range (IQR), 73\u201387, 30.5% females] were randomized across 13 sites between December 2020 and March 2023. Half of the participants (n = 82) had an ejection fraction &amp;gt;50%. Most patients showed a high burden of comorbidities, with a median Charlson index of 3 (IQR: 2\u20134). Common co-morbidities included diabetes mellitus (41%, n = 69), atrial fibrillation (80%, n = 134), and chronic kidney disease (64%, n = 107).<\/jats:p>\n                    <jats:p>Patients exhibited a poor functional NYHA class (69% presenting NYHA III) and several signs of congestion. The mean composite congestion score was 4.3 (standard deviation: 1.7). Ninety per cent of the patients (n = 151) presented oedema and jugular engorgement, and 71% (n = 118) showed lung B lines assessed by ultrasound. Median inferior vena cava diameter was 23 mm, (IQR: 21\u201325), and plasmatic levels of N-terminal-pro-B-type natriuretic peptide (NTproBNP) and antigen carbohydrate 125 (CA125) were increased (median NT-proBNP 4969 pg\/mL, IQR: 2508\u20139328; median CA125 46 U\/L, IQR: 20\u2013114).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>SALT-HF trial randomized 167 ambulatory patients with WHF and will determine whether an infusion of hypertonic saline therapy plus furosemide increases diuresis and improves decongestion compared to equivalent furosemide administration alone.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ehf2.14720","type":"journal-article","created":{"date-parts":[[2024,2,21]],"date-time":"2024-02-21T08:09:24Z","timestamp":1708502964000},"page":"1767-1776","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Design and Baseline Characteristics of SALT-HF Trial: Hypertonic Saline Therapy in Ambulatory Heart Failure"],"prefix":"10.1093","volume":"11","author":[{"given":"M.","family":"Cobo Marcos","sequence":"first","affiliation":[{"name":"Department of Cardiology, Hospital Universitario Puerta de Hierro , Madrid ,","place":["Spain"]},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red (CIBER Cardiovascular) , Madrid ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Com\u00edn-Colet","sequence":"additional","affiliation":[{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red (CIBER Cardiovascular) , Madrid ,","place":["Spain"]},{"name":"Department of Cardiology, Hospital Universitario de Bellvitge, IDIBELL , Barcelona ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"de la Espriella","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hospital Cl\u00ednico Universitario de Valencia (INCLIVA), University of Valencia , Valencia ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Rubio Gracia","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Hospital Universitario Lozano Blesa, University of Zaragoza, Aragon Health Research Institute (IIS Aragon) , Zaragoza ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. L.","family":"Morales-Rull","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Hospital Universitario Arnau de Vilanova , Lleida ,","place":["Spain"]},{"name":"Heart Failure Unit, Lleida Health Region, Institut de Recerca Biom\u00e8dica de Lleida (IRBLleida) , Lleida ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I.","family":"Zegr\u00ed","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hospital de la Santa Creu i Sant Pau , Barcelona ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Llacer","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Hospital Universitario Ram\u00f3n y Cajal, IRYCIS , Madrid ,","place":["Spain"]},{"name":"Department of Medicine and Medical Specialties, Facultad de Medicina y Ciencias de la Salud, Universidad de Alcal\u00e1 , Madrid ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Diez-Villanueva","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hospital Universitario de la Princesa , Madrid ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Jim\u00e9nez-Marrero","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hospital Universitario de Bellvitge, IDIBELL , Barcelona ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"de Juan Bagud\u00e1","sequence":"additional","affiliation":[{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red (CIBER Cardiovascular) , Madrid ,","place":["Spain"]},{"name":"Department of Cardiology, University Hospital 12 de Octubre, Instituto de Investigaci\u00f3n Sanitaria Hospital 12 de Octubre (imas12) , Madrid ,","place":["Spain"]},{"name":"Instituto de Salud Carlos III , Madrid ,","place":["Spain"]},{"name":"Department of Medicine, Faculty of Biomedical and Health Science, Universidad Europea de Madrid , Madrid ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Ortiz Cort\u00e9s","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hospital Universitario San Pedro de Alc\u00e1ntara , C\u00e1ceres ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Goirigolzarri-Artaza","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hospital Universitario Cl\u00ednico San Carlos , Madrid ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. 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