{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T13:25:16Z","timestamp":1783430716675,"version":"3.54.6"},"reference-count":41,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2023,9,1]],"date-time":"2023-09-01T00:00:00Z","timestamp":1693526400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"},{"start":{"date-parts":[[2023,9,7]],"date-time":"2023-09-07T00:00:00Z","timestamp":1694044800000},"content-version":"vor","delay-in-days":6,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Decongestion strategies for acute decompensated heart failure (ADHF) characterized by volume overload differ widely. The aim of this independent international academic web-based survey was to capture the therapeutic strategies that physicians use to treat ADHF and to assess differences in therapeutic approaches between cardiologists versus non-cardiologists.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>Physicians were invited to complete a web-based questionnaire, capturing anonymized data on physicians' characteristics and treatment preferences based on a hypothetical clinical scenario of a patient hospitalized with ADHF. A total of 641 physicians from 60 countries participated. A wide variation in the management of the patient was observed. There was conservative use of diuretics, i.e. only 7% started intravenous furosemide at a dose \u22652 times the baseline oral dose, and infrequent use of ultrasound in assessing congestion (20.4%). Spot urinary sodium was infrequently or never measured by \u226585% of physicians. A third considered a patient with ongoing oedema as being stabilized. There were significant differences between cardiologists and non-cardiologists in the management of ADHF, the targets for daily body weight loss and urine output, diuretic escalation strategies (66.3% vs. 40.7% would escalate diuresis by adding a thiazide) and assessment of response to treatment (27.0% vs. 52.9% considered patients with minimal congestion as stabilized).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>There is substantial variability amongst physicians and between cardiologists and non-cardiologists in the management of patients with ADHF, with regard to clinical parameters used to tailor treatment, treatment goals, diuretic dosing and escalation strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ejhf.2985","type":"journal-article","created":{"date-parts":[[2023,8,10]],"date-time":"2023-08-10T05:08:05Z","timestamp":1691644085000},"page":"1555-1570","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Decongestion Strategies In Patients Presenting with Acutely Decompensated Heart Failure: A Worldwide Survey Among Physicians"],"prefix":"10.1093","volume":"25","author":[{"given":"Ali","family":"Vazir","sequence":"first","affiliation":[{"name":"Royal Brompton Hospital, Royal Brompton and Harefield Hospitals Part of Guy's and St Thomas' NHS Foundation Trust , London ,","place":["UK"]},{"name":"National Heart and Lung Institute, Imperial College London , London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chris J.","family":"Kapelios","sequence":"additional","affiliation":[{"name":"Royal Brompton Hospital, Royal Brompton and Harefield Hospitals Part of Guy's and St Thomas' NHS Foundation Trust , London ,","place":["UK"]},{"name":"National and Kapodistrian University of Athens , Athens ,","place":["Greece"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elif","family":"Agaoglu","sequence":"additional","affiliation":[{"name":"Royal Brompton Hospital, Royal Brompton and Harefield Hospitals Part of Guy's and St Thomas' NHS Foundation Trust , London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Metra","sequence":"additional","affiliation":[{"name":"Cardiology, ASST Spedali Civili, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia , Brescia ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yury","family":"Lopatin","sequence":"additional","affiliation":[{"name":"Volgograd State Medical University, Regional Cardiology Centre , Volgograd ,","place":["Russia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petar","family":"Seferovic","sequence":"additional","affiliation":[{"name":"University of Belgrade Faculty of Medicine , Belgrade ,","place":["Serbia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wilfred","family":"Mullens","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Ziekenhuis Oost-Limburg, Genk, Belgium; Biomedical Research Institute, Faculty of Medicine and Life Sciences, Hasselt University , Diepenbeek ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerasimos","family":"Filippatos","sequence":"additional","affiliation":[{"name":"National & Kapodistrian University of Athens, School of Medicine, Attikon University Hospital Athens , Athens ,","place":["Greece"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Rosano","sequence":"additional","affiliation":[{"name":"St George's Hospitals, NHS Trust, University of London , London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew J.S.","family":"Coats","sequence":"additional","affiliation":[{"name":"University of Warwick , Coventry ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ovidiu","family":"Chioncel","sequence":"additional","affiliation":[{"name":"Emergency Institute for Cardiovascular Diseases \u2018Prof. C.C. Iliescu\u2019, Bucharest, Romania, University of Medicine Carol Davila , Bucharest ,","place":["Romania"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,9,7]]},"reference":[{"key":"2026010913102309800_ejhf2985-bib-0001","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1016\/j.ahj.2004.08.005","article-title":"Characteristics and outcomes of patients hospitalized for heart failure in the United States: Rationale, design, and preliminary observations from the first 100,000 cases in the Acute Decompensated Heart Failure National Registry (ADHERE)","volume":"149","author":"Adams","year":"2005","journal-title":"Am Heart J"},{"key":"2026010913102309800_ejhf2985-bib-0002","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1002\/ejhf.1369","article-title":"The use of diuretics in heart failure with congestion \u2013 A position statement from the Heart Failure Association of the European Society of Cardiology","volume":"21","author":"Mullens","year":"2019","journal-title":"Eur J Heart Fail"},{"key":"2026010913102309800_ejhf2985-bib-0003","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1093\/ehjcvp\/pvx020","article-title":"Loop diuretics for chronic heart failure: A foe in disguise of a friend?","volume":"4","author":"Kapelios","year":"2018","journal-title":"Eur Heart J Cardiovasc Pharmacother"},{"key":"2026010913102309800_ejhf2985-bib-0004","doi-asserted-by":"crossref","first-page":"422","DOI":"10.1016\/j.cardfail.2007.03.011","article-title":"High prevalence of renal dysfunction and its impact on outcome in 118,465 patients hospitalized with acute decompensated heart failure: A report from the ADHERE database","volume":"13","author":"Heywood","year":"2007","journal-title":"J Card Fail"},{"key":"2026010913102309800_ejhf2985-bib-0005","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1002\/ejhf.2333","article-title":"2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: Developed by the Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). 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