{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T17:46:50Z","timestamp":1791827210853,"version":"4.3.4"},"reference-count":30,"publisher":"Springer Science and Business Media LLC","issue":"11","license":[{"start":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T00:00:00Z","timestamp":1790553600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T00:00:00Z","timestamp":1790553600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Clin Res Cardiol"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>Natriuresis-guided therapy has been proposed as a personalized approach for decongestion in acute heart failure (HF). Given the evidence of sex-related differences in response to decongestive therapy, we performed a sex-specific analysis on the treatment effect of natriuresis-guided therapy in the PUSH-AHF trial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The PUSH-AHF trial randomized 310 patients (45% women) to natriuresis-guided therapy or standard of care (SOC). The endpoints of PUSH-AHF were compared between men and women. The 24-h natriuretic response was calculated as 24-h natriuresis divided by the total 24-h loop diuretic dose (mg of bumetanide equivalents).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In men, mean total 24-h natriuresis was greater with natriuresis-guided therapy compared to SOC (443 vs. 354\u00a0mmol,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.004), whereas in women, this was similar between the groups (357 vs. 336\u00a0mmol,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.533, adjusted\n                      <jats:italic>p<\/jats:italic>\n                      -interaction\u2009=\u20090.276). The median 24-h natriuretic response was lower in women receiving natriuresis-guided therapy (23 vs. 52\u00a0mmol urinary sodium\/mg bumetanide,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001) when compared to SOC, whereas in men, there was no significant difference between treatment arms (38 vs. 45\u00a0mmol respectively,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.337, adjusted\n                      <jats:italic>p<\/jats:italic>\n                      -interaction\u2009=\u20090.009). Natriuresis-guided therapy was associated with a lower risk of 180-day HF rehospitalization or all-cause mortality in men (adjusted HR 0.51 (95% CI, 0.30\u20130.86;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.011), but not in women (adjusted HR 1.40 (95% CI, 0.67\u20132.91;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.368), adjusted\n                      <jats:italic>p<\/jats:italic>\n                      -interaction\u2009=\u20090.026).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Natriuresis-guided therapy was associated with greater natriuresis and a lower risk of 180-day all-cause mortality or HF rehospitalization in men but not in women. These exploratory sex-specific patterns warrant further investigation and confirmation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00392-026-03030-1","type":"journal-article","created":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T10:52:06Z","timestamp":1790592726000},"page":"2062-2076","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effects of natriuresis-guided diuretic therapy in men and women with acute heart failure: insights from PUSH-AHF"],"prefix":"10.1007","volume":"115","author":[{"given":"Hailun","family":"Qin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lara E. E. 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The employer of IEB receives speaker fees by Novartis. The employer of AAV received consultancy fees and\/or research support from Adrenomed, Anacardio, AstraZeneca, Bayer AG, BMS, Boehringer Ingelheim, Cardurion, Corteria, EliLilly, Merck, Moderna, Novartis, Novo Nordisk, and Rycarma, SalubrisBio. KD reports consultancy\/speaker fees to institution by Abbott, AstraZeneca, Boehringer Ingelheim, Novartis, Echosense, and FIRE1. PvdM reports institutional payments for consultancy fees or grants from AstraZeneca, Boehringer Ingelheim, BridgeBio, Ionis, Novartis, Novo Nordisk, Pfizer, Pharmacosmos, Pharma Nord, and Vifor. All other authors have no relevant disclosures.","order":1,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Declarations"}}]}}