{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T19:33:43Z","timestamp":1792870423262,"version":"4.5.0"},"reference-count":33,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2022,9,6]],"date-time":"2022-09-06T00:00:00Z","timestamp":1662422400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100001491","name":"Belgian American Educational Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100001491","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["European J of Heart Fail"],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>Intrinsic renal sodium avidity (IRSA) is a hallmark feature of acute heart failure (AHF) and can be measured by evaluating the urinary sodium (UNa) concentration. The aim of this study is to assess the role of measuring IRSA through a random Una\u2010sample and its association with decongestive response.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>\n                      A post\u2010hoc analysis of the ROSE\u2010AHF trial was performed in all patients with a random UNa spot sample before randomization (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a0339\/360). Patients were categorized according to tertiles of UNa as high (range 19\u201340\u2009mmol\/L), intermediate (range 41\u201368\u2009mmol\/L), or low (range 69\u2013139\u2009mmol\/L) IRSA. Linear mixed effect models and ANCOVA were used to assess the relation with decongestive effectiveness measured by: (i) weight change, (ii) visual analogue scale (VAS) improvement, (iii) N\u2010terminal pro\u2010B\u2010type natriuretic peptide (NT\u2010proBNP) change, (iv) natriuretic response (UNa in mmol\/L), (v) 72\u2009h natriuresis (mmol), (vi) oedema resolution, and (vii) length of stay. High IRSA patients had less improvement in decongestive metrics, including weight loss (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.028), VAS improvement, NT\u2010proBNP decrease, natriuretic response (\n                      <jats:italic>p<\/jats:italic>\n                      \u2010time interaction &lt;0.001 for all), had lower total natriuresis (high IRSA 438\u2009\u00b1\u2009141\u2009mmol, intermediate IRSA 526\u2009\u00b1\u2009320\u2009mmol, and low IRSA 603\u2009\u00b1\u2009276\u2009mmol;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), exhibited more oedema at 72\u2009h (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.005), and had a longer length of stay (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.015). Incremental loop diuretic dose titration (\u00b1\u20094\u00a0times home dose) after &gt;24\u2009h, resulted in an increase in natriuretic response in the high IRSA group, however cumulative natriuresis still remained lower at 72\u2009h (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Longitudinal UNa profiling of patients with low IRSA showed physiologic breaking in the UNa pattern, associated with attaining decongestion and slight increase in creatinine and cystatin C, forming a potential signal of complete decongestion.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>A simple random UNa sample at the time of AHF, gives insight into IRSA which is consistently associated with decongestive effectiveness across multiple metrics, offering an opportunity for early AHF care improvement.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ejhf.2662","type":"journal-article","created":{"date-parts":[[2022,8,23]],"date-time":"2022-08-23T23:43:31Z","timestamp":1661298211000},"page":"1978-1987","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":33,"title":["Assessing intrinsic renal sodium avidity in acute heart failure: implications in predicting and guiding decongestion"],"prefix":"10.1093","volume":"24","author":[{"given":"Pieter","family":"Martens","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic  Cleveland OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Horng H.","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Mayo Clinic  Rochester MN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frederik H.","family":"Verbrugge","sequence":"additional","affiliation":[{"name":"Centre for Cardiovascular Diseases University Hospital Brussels  Jette Belgium"},{"name":"Faculty of Medicine and Pharmacy Vrije Universiteit Brussel  Brussels Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey T.","family":"Testani","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Yale School of Medicine  New Haven CT USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wilfried","family":"Mullens","sequence":"additional","affiliation":[{"name":"Ziekenhuis Oost Limburg, Genk and University Hasselt  Hasselt Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W.H. Wilson","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic  Cleveland OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,9,6]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.1369"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(97)08417-1"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1801291"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1100171"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1601895"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1005419"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.2384"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2015.05.003"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrcardio.2014.215"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.115.002845"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.109.933275"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.111.963256"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.05.027"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.113.000895"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/ehf2.13666"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.2385"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchf.2019.02.011"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehab650"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehab620"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2013.282190"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchf.2019.01.007"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.115.002370"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cardfail.2018.04.002"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/clc.23286"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.1713"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.1307"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cardfail.2015.11.003"},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.2587"},{"key":"e_1_2_6_30_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2203094"},{"key":"e_1_2_6_31_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1703100"},{"key":"e_1_2_6_32_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.2333"},{"key":"e_1_2_6_33_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.117.030112"},{"key":"e_1_2_6_34_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.1697"}],"container-title":["European Journal of Heart Failure"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ejhf.2662","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ejhf.2662","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ejhf.2662","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T12:16:05Z","timestamp":1767701765000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ejhf.2662"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9,6]]},"references-count":33,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2022,10]]}},"alternative-id":["10.1002\/ejhf.2662"],"URL":"https:\/\/doi.org\/10.1002\/ejhf.2662","archive":["Portico"],"relation":{},"ISSN":["1388-9842","1879-0844"],"issn-type":[{"value":"1388-9842","type":"print"},{"value":"1879-0844","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,9,6]]},"assertion":[{"value":"2022-06-12","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-08-19","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-09-06","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}