{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T20:40:19Z","timestamp":1791319219503,"version":"4.3.1"},"reference-count":19,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T00:00:00Z","timestamp":1771372800000},"content-version":"vor","delay-in-days":327,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,3,28]],"date-time":"2025-03-28T00:00:00Z","timestamp":1743120000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/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"}]},{"name":"CIBER CV","award":["16\/11\/00420"],"award-info":[{"award-number":["16\/11\/00420"]}]},{"name":"CIBER CV","award":["16\/11\/00432"],"award-info":[{"award-number":["16\/11\/00432"]}]},{"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":[[2025,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Early diuresis and natriuresis are commonly used to assess the efficacy of decongestive therapy following an acute heart failure episode. There is limited knowledge regarding which parameter better predicts adverse clinical outcomes, especially in the outpatient setting. This study investigated the prognostic value of both metrics in predicting 30-day adverse clinical events in an ambulatory worsening heart failure (WHF) scenario.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>This is a post-hoc analysis of the SALT-HF trial involving 167 patients with ambulatory WHF randomized to receive intravenous furosemide with or without hypertonic saline solution. Early diuretic response was assessed through 3-h urine output and 3-h urinary sodium (uNa+) levels following intravenous (IV) diuretic infusion. We analysed their association with 30-day adverse events (defined as death, heart failure hospitalization, or the need for outpatient IV diuretics) using logistic regression analysis. Both exposures were examined along the continuum and dichotomized in their median. The discriminative ability between the exposures and endpoints was assessed by receiver operating characteristic curves (AUC-ROC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The median age of participants was 81 years, predominantly male (69.5%). Patients with lower 3-h urinary sodium and diuresis were older and exhibited reduced kidney function and haemoglobin levels. At 30 days, 50 (29.9%) of the sample experienced the composite endpoint. Multivariate analyses revealed that lower 3-h uNa+ was associated with a higher risk of 30-day adverse events (P = 0.008). Conversely, 3-h diuresis did not significantly predict 30-day adverse outcomes (P = 0.424). There was a trend towards a higher AUC-ROC for the inverse of 3-h natriuresis compared with 3-h diuresis: 0.680 versus 0.601, P = 0.092.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In patients with ambulatory WHF treated with IV furosemide, 3-h urinary sodium predicted 30-day outcomes whereas 3-h diuresis did not.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ehf2.15275","type":"journal-article","created":{"date-parts":[[2025,3,30]],"date-time":"2025-03-30T17:20:33Z","timestamp":1743355233000},"page":"2460-2466","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Early Diuretic Response and Outcome Prediction in Ambulatory Worsening Heart Failure: Natriuresis Versus Diuresis"],"prefix":"10.1093","volume":"12","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":"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":"I.","family":"Zegri-Reiriz","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":"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.","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":"J. L.","family":"Morales-Rull","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Hospital Universitario Arnau de Vilanova, Heart Failure Unit, Lleida Health Region, Institut de Recerca Biom\u00e8dica de Lleida (IRBLleida) , Lleida ,","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":"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":"Department of Medicine, Faculty of Biomedical and Health Science, Universidad Europea de Madrid , Madrid ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Jim\u00e9nez-Marrero","sequence":"additional","affiliation":[{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red (CIBER Cardiovascular) , Madrid ,","place":["Spain"]},{"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":"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":"M. A.","family":"Restrepo-C\u00f3rdoba","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hospital Universitario Cl\u00ednico San Carlos , Madrid ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. M.","family":"Garc\u00eda-Pinilla","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hospital Universitario Virgen de la Victoria , M\u00e1laga ,","place":["Spain"]},{"name":"Instituto de Investigaci\u00f3n Biom\u00e9dica-Plataforma BIONAND. M\u00e1laga Ciber-Cardiovascular, Instituto de Salud Carlos III, Departamento de Medicina y Dermatolog\u00eda, Universidad de M\u00e1laga , M\u00e1laga ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Barrios","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hospital Universitario Rey Juan Carlos M\u00f3stoles , Madrid ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"del Prado D\u00edaz","sequence":"additional","affiliation":[{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red (CIBER Cardiovascular) , Madrid ,","place":["Spain"]},{"name":"Department of Cardiology, Hospital Universitario Ram\u00f3n y Cajal , Madrid ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"N\u00fa\u00f1ez","sequence":"additional","affiliation":[{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red (CIBER Cardiovascular) , Madrid ,","place":["Spain"]},{"name":"Department of Cardiology, Hospital Cl\u00ednico Universitario de Valencia (INCLIVA), University of Valencia , Valencia ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,3,28]]},"reference":[{"key":"2026021804083730100_ehf215275-bib-0001","doi-asserted-by":"publisher","first-page":"3599","DOI":"10.1093\/eurheartj\/ehab368","article-title":"2021 ESC guidelines for the diagnosis and treatment of acute and chronic heart failure","volume":"42","author":"McDonagh","year":"2021","journal-title":"Eur Heart J"},{"key":"2026021804083730100_ehf215275-bib-0002","doi-asserted-by":"publisher","first-page":"383","DOI":"10.1016\/j.jchf.2019.01.007","article-title":"Natriuretic response is highly variable and associated with 6-month survival: insights from the ROSE-AHF trial","volume":"7","author":"Hodson","year":"2019","journal-title":"JACC Heart 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