{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T23:32:27Z","timestamp":1787959947906,"version":"build-2784847793"},"reference-count":22,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2005,8,1]],"date-time":"2005-08-01T00:00:00Z","timestamp":1122854400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2005,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Loop diuretics are beneficial in heart failure in the short term because they eliminate fluid retention, but in the long-term, they could adversely influence prognosis due to activation of neurohumoral mechanisms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To explore the changes induced by diuretic withdrawal in chronic nonadvanced heart failure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Diuretics were withdrawn in 26 stabilized heart failure patients with systolic dysfunction (ejection fraction [EF]&amp;lt;45%). Clinical status was evaluated by physical exam, exercise capacity (corridor test) and New York Heart Association (NYHA) class. Biochemical and neurohumoral determinations were performed at baseline and at 3 months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>At 3 months, 17 out of 26 patients (65%) were able to tolerate diuretic interruption without a deterioration in exercise capacity or New York Heart Association functional class. Renal function parameters improved (baseline urea 46.2\u00b110.8 to 39.2\u00b110.1 mg\/dl at 3 months, p=0.014; creatinine 1.1\u00b10.23 to 0.98\u00b10.2 mg\/dl, p=0.013). Glucose metabolism also improved (fasting glucose 151\u00b191 to 122\u00b114 mg\/dl, p=0.035). Heart rate and systolic blood pressure did not significantly change, while diastolic blood pressure increased (from 80\u00b110 to 87\u00b113 mm Hg, p=0.006). Neurohumoral determinations showed a decrease in plasma renin activity (4.19\u00b15.96 to 2.88\u00b14.98 ng\/ml, p=0.026), with no changes in aldosterone, arginine-vasopressin, endothelin-1 and norepinephrine. In contrast, atrial natriuretic peptide significantly increased (115\u00b187 to 168\u00b1155 pg\/ml, p=0.004).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Diuretic withdrawal in stabilized heart failure with systolic dysfunction is associated with an improvement in renal function parameters, glucose metabolism and some neurohumoral parameters, such as plasma renin activity; however, atrial natriuretic peptide levels increased.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.ejheart.2004.09.006","type":"journal-article","created":{"date-parts":[[2005,3,16]],"date-time":"2005-03-16T07:14:06Z","timestamp":1110957246000},"page":"892-898","source":"Crossref","is-referenced-by-count":47,"title":["Clinical and Neurohumoral Consequences of Diuretic Withdrawal in Patients with Chronic, Stabilized Heart Failure and Systolic Dysfunction"],"prefix":"10.1093","volume":"7","author":[{"given":"Enrique","family":"Galve","sequence":"first","affiliation":[{"name":"Servei de Cardiologia, Hospital General Universitari Vall d\u2019Hebron , Pg Vall d\u2019Hebron 119-129, 08035, Barcelona ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Mallol","sequence":"additional","affiliation":[{"name":"Servei de Cardiologia, Hospital General Universitari Vall d\u2019Hebron , Pg Vall d\u2019Hebron 119-129, 08035, Barcelona ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Catalan","sequence":"additional","affiliation":[{"name":"Servei de Bioqu\u00edmica, Hospital General Universitari Vall d\u2019Hebron , Barcelona ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jordi","family":"Palet","sequence":"additional","affiliation":[{"name":"Servei de Cardiologia, Hospital General Universitari Vall d\u2019Hebron , Pg Vall d\u2019Hebron 119-129, 08035, Barcelona ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stella","family":"M\u00e9ndez","sequence":"additional","affiliation":[{"name":"Servei de Cardiologia, Hospital General Universitari Vall d\u2019Hebron , Pg Vall d\u2019Hebron 119-129, 08035, Barcelona ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elsa","family":"Nieto","sequence":"additional","affiliation":[{"name":"Servei de Cardiologia, Hospital General Universitari Vall d\u2019Hebron , Pg Vall d\u2019Hebron 119-129, 08035, Barcelona ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Diaz","sequence":"additional","affiliation":[{"name":"Servei de Cardiologia, Hospital General Universitari Vall d\u2019Hebron , Pg Vall d\u2019Hebron 119-129, 08035, Barcelona ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jordi","family":"Soler-Soler","sequence":"additional","affiliation":[{"name":"Servei de Cardiologia, Hospital General Universitari Vall d\u2019Hebron , Pg Vall d\u2019Hebron 119-129, 08035, Barcelona ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2005,8,7]]},"reference":[{"key":"2026020203562639700_ejhf2004-09-006-bib-0001","doi-asserted-by":"crossref","first-page":"1126","DOI":"10.1161\/01.CIR.102.10.1126","article-title":"Evidence of improving prognosis in heart failure","volume":"102","author":"McIntyre","year":"2000","journal-title":"Circulation"},{"key":"2026020203562639700_ejhf2004-09-006-bib-0002","doi-asserted-by":"crossref","first-page":"966","DOI":"10.1016\/S0735-1097(86)80442-9","article-title":"Physician practice in the management of congestive heart failure","volume":"4","author":"Hlatky","year":"1986","journal-title":"J. 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