{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,12]],"date-time":"2026-11-12T17:48:28Z","timestamp":1794505708576,"version":"4.9.1"},"reference-count":29,"publisher":"Springer Science and Business Media LLC","issue":"6","license":[{"start":{"date-parts":[[2025,3,30]],"date-time":"2025-03-30T00:00:00Z","timestamp":1743292800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2025,3,30]],"date-time":"2025-03-30T00:00:00Z","timestamp":1743292800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Nat Med"],"published-print":{"date-parts":[[2025,6]]},"DOI":"10.1038\/s41591-025-03628-4","type":"journal-article","created":{"date-parts":[[2025,3,30]],"date-time":"2025-03-30T09:02:14Z","timestamp":1743325334000},"page":"2062-2068","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":49,"title":["Liberal fluid intake versus fluid restriction in chronic heart failure: a randomized clinical trial"],"prefix":"10.1038","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5923-3720","authenticated-orcid":false,"given":"Job J.","family":"Herrmann","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans-Peter","family":"Brunner-La Rocca","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisette E. H. J. M.","family":"Baltussen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabienne","family":"Beckers-Wesche","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastiaan C. A. M.","family":"Bekkers","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louise","family":"Bellersen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. W. Martijn","family":"van Eck","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H. Carlijne","family":"Hassing","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiny","family":"Jaarsma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3339-1955","authenticated-orcid":false,"given":"Gerard C. M.","family":"Linssen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ron","family":"Pisters","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra","family":"Sanders-van Wijk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marjolein H. I.","family":"Verdijk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8942-7865","authenticated-orcid":false,"given":"M. Louis","family":"Handoko","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9705-4413","authenticated-orcid":false,"given":"Peter","family":"van der Meer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0599-9290","authenticated-orcid":false,"given":"Frederik H.","family":"Verbrugge","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr","given":"James L.","family":"Januzzi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antoni","family":"Bay\u00e9s-Gen\u00eds","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robby","family":"Nieuwlaat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Rodwell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D. H. Frank","family":"Gommans","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8207-8906","authenticated-orcid":false,"given":"Roland R. J.","family":"van Kimmenade","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,3,30]]},"reference":[{"key":"3628_CR1","doi-asserted-by":"publisher","first-page":"86","DOI":"10.1016\/j.hrtlng.2020.08.002","volume":"50","author":"SH Eng","year":"2021","unstructured":"Eng, S. H. et al. Thirst and factors associated with frequent thirst in patients with heart failure in Spain. Heart Lung 50, 86\u201391 (2021).","journal-title":"Heart Lung"},{"key":"3628_CR2","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1097\/JCN.0000000000000607","volume":"35","author":"MHL van der Wal","year":"2020","unstructured":"van der Wal, M. H. L., Waldreus, N., Jaarsma, T. & Kato, N. P. Thirst in patients with heart failure in Sweden, the Netherlands, and Japan. J. Cardiovasc. Nurs. 35, 19\u201325 (2020).","journal-title":"J. Cardiovasc. Nurs."},{"key":"3628_CR3","doi-asserted-by":"publisher","first-page":"2181","DOI":"10.1002\/ehf2.13960","volume":"9","author":"MHL van der Wal","year":"2022","unstructured":"van der Wal, M. H. L., Jaarsma, T., Jenneboer, L. C. & Linssen, G. C. M. Thirst in stable heart failure patients; time to reconsider fluid restriction and prescribed diuretics. ESC Heart Fail. 9, 2181\u20132188 (2022).","journal-title":"ESC Heart Fail."},{"key":"3628_CR4","doi-asserted-by":"publisher","first-page":"1555","DOI":"10.1002\/ejhf.2985","volume":"25","author":"A Vazir","year":"2023","unstructured":"Vazir, A. et al. Decongestion strategies in patients presenting with acutely decompensated heart failure: a worldwide survey among physicians. Eur. J. Heart Fail. 25, 1555\u20131570 (2023).","journal-title":"Eur. J. Heart Fail."},{"key":"3628_CR5","unstructured":"Hoog, L., Stromberg, A., Waldreus, N. & Nymark, C. A national survey of healthcare professional\u2019s clinical practice on fluid intake in patients with heart failure. Abstract. Eur. J. Heart Fail. 26 (S2), 3\u2013643 (2024)."},{"key":"3628_CR6","doi-asserted-by":"publisher","first-page":"63","DOI":"10.1007\/s00059-015-4345-9","volume":"41","author":"R De Vecchis","year":"2016","unstructured":"De Vecchis, R., Baldi, C., Cioppa, C., Giasi, A. & Fusco, A. Effects of limiting fluid intake on clinical and laboratory outcomes in patients with heart failure. Results of a meta-analysis of randomized controlled trials. Herz 41, 63\u201375 (2016).","journal-title":"Herz"},{"key":"3628_CR7","doi-asserted-by":"publisher","first-page":"192","DOI":"10.1536\/ihj.14-288","volume":"56","author":"Y Li","year":"2015","unstructured":"Li, Y., Fu, B. & Qian, X. Liberal versus restricted fluid administration in heart failure patients. A systematic review and meta-analysis of randomized trials. Int. Heart J. 56, 192\u2013195 (2015).","journal-title":"Int. Heart J."},{"key":"3628_CR8","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.cardfail.2012.11.007","volume":"19","author":"NM Albert","year":"2013","unstructured":"Albert, N. M., Nutter, B., Forney, J., Slifcak, E. & Tang, W. H. A randomized controlled pilot study of outcomes of strict allowance of fluid therapy in hyponatremic heart failure (SALT-HF). J. Card. Fail. 19, 1\u20139 (2013).","journal-title":"J. Card. Fail."},{"key":"3628_CR9","doi-asserted-by":"publisher","first-page":"316","DOI":"10.1080\/14017430802071200","volume":"42","author":"M Holst","year":"2008","unstructured":"Holst, M., Stromberg, A., Lindholm, M. & Willenheimer, R. Liberal versus restricted fluid prescription in stabilised patients with chronic heart failure: result of a randomised cross-over study of the effects on health-related quality of life, physical capacity, thirst and morbidity. Scand. Cardiovasc. J. 42, 316\u2013322 (2008).","journal-title":"Scand. Cardiovasc. J."},{"key":"3628_CR10","first-page":"A19846","volume":"136","author":"CM Reilly","year":"2017","unstructured":"Reilly, C. M., Higgins, M. & Dunbar, S. B. Clinical, symptom, functional, and QOL outcomes in a trial of prescribed fluid restrictions in persons with heart failure. Circulation 136, A19846 (2017).","journal-title":"Circulation"},{"key":"3628_CR11","doi-asserted-by":"publisher","first-page":"128","DOI":"10.1016\/j.cardfail.2006.10.012","volume":"13","author":"B Travers","year":"2007","unstructured":"Travers, B. et al. Fluid restriction in the management of decompensated heart failure: no impact on time to clinical stability. J. Card. Fail. 13, 128\u2013132 (2007).","journal-title":"J. Card. Fail."},{"key":"3628_CR12","doi-asserted-by":"publisher","first-page":"2318","DOI":"10.1111\/j.1365-2702.2008.02295.x","volume":"17","author":"M Holst","year":"2008","unstructured":"Holst, M., Stromberg, A., Lindholm, M. & Willenheimer, R. Description of self-reported fluid intake and its effects on body weight, symptoms, quality of life and physical capacity in patients with stable chronic heart failure. J. Clin. Nurs. 17, 2318\u20132326 (2008).","journal-title":"J. Clin. Nurs."},{"key":"3628_CR13","doi-asserted-by":"publisher","first-page":"141","DOI":"10.1093\/eurjhf\/hfs174","volume":"15","author":"N Waldreus","year":"2013","unstructured":"Waldreus, N., Hahn, R. G. & Jaarsma, T. Thirst in heart failure: a systematic literature review. Eur. J. Heart Fail. 15, 141\u2013149 (2013).","journal-title":"Eur. J. Heart Fail."},{"key":"3628_CR14","doi-asserted-by":"publisher","first-page":"2223","DOI":"10.2147\/PPA.S167724","volume":"12","author":"N Waldreus","year":"2018","unstructured":"Waldreus, N., Chung, M. L., van der Wal, M. H. & Jaarsma, T. Trajectory of thirst intensity and distress from admission to 4-weeks follow up at home in patients with heart failure. Patient Prefer. Adherence 12, 2223\u20132231 (2018).","journal-title":"Patient Prefer. Adherence"},{"key":"3628_CR15","doi-asserted-by":"publisher","first-page":"434","DOI":"10.1093\/eurheartj\/ehi603","volume":"27","author":"MH van der Wal","year":"2006","unstructured":"van der Wal, M. H. et al. Compliance in heart failure patients: the importance of knowledge and beliefs. Eur. Heart J. 27, 434\u2013440 (2006).","journal-title":"Eur. Heart J."},{"key":"3628_CR16","doi-asserted-by":"publisher","first-page":"e263","DOI":"10.1016\/j.jacc.2021.12.012","volume":"79","author":"PA Heidenreich","year":"2022","unstructured":"Heidenreich, P. A. et al. 2022 AHA\/ACC\/HFSA Guideline for the Management of Heart Failure: a report of the American College of Cardiology\/American Heart Association Joint Committee on Clinical Practice Guidelines. J. Am. Coll. Cardiol. 79, e263\u2013e421 (2022).","journal-title":"J. Am. Coll. Cardiol."},{"key":"3628_CR17","doi-asserted-by":"publisher","first-page":"3599","DOI":"10.1093\/eurheartj\/ehab368","volume":"42","author":"TA McDonagh","year":"2021","unstructured":"McDonagh, T. A. et al. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur. Heart J. 42, 3599\u20133726 (2021).","journal-title":"Eur. Heart J."},{"key":"3628_CR18","doi-asserted-by":"publisher","first-page":"730","DOI":"10.1002\/ejhf.3244","volume":"26","author":"W Mullens","year":"2024","unstructured":"Mullens, W. et al. Dietary sodium and fluid intake in heart failure. A clinical consensus statement of the Heart Failure Association of the ESC. Eur. J. Heart Fail. 26, 730\u2013741 (2024).","journal-title":"Eur. J. Heart Fail."},{"key":"3628_CR19","doi-asserted-by":"publisher","first-page":"2379","DOI":"10.1016\/j.jacc.2020.09.542","volume":"76","author":"JA Spertus","year":"2020","unstructured":"Spertus, J. A., Jones, P. G., Sandhu, A. T. & Arnold, S. V. Interpreting the Kansas City Cardiomyopathy Questionnaire in clinical trials and clinical care: JACC State-of-the-Art Review. J. Am. Coll. Cardiol. 76, 2379\u20132390 (2020).","journal-title":"J. Am. Coll. Cardiol."},{"key":"3628_CR20","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1001\/jamacardio.2024.4470","volume":"10","author":"M Abdel Jawad","year":"2025","unstructured":"Abdel Jawad, M. et al. Interpreting population mean treatment effects in the Kansas City Cardiomyopathy Questionnaire: a patient-level meta-analysis. JAMA Cardiol. 10, 32\u201340 (2025).","journal-title":"JAMA Cardiol."},{"key":"3628_CR21","doi-asserted-by":"publisher","first-page":"1531","DOI":"10.1016\/j.cardfail.2022.07.054","volume":"28","author":"A Merlo","year":"2022","unstructured":"Merlo, A., Mezue, K. & Ambrosy, A. P. Fluid restriction recommendations in heart failure: dry as a bone or quench your thirst? J. Card. Fail. 28, 1531\u20131533 (2022).","journal-title":"J. Card. Fail."},{"key":"3628_CR22","doi-asserted-by":"publisher","first-page":"1522","DOI":"10.1016\/j.cardfail.2022.05.015","volume":"28","author":"JJ Herrmann","year":"2022","unstructured":"Herrmann, J. J. et al. Fluid REStriction in heart failure vs liberal fluid UPtake: rationale and design of the randomized FRESH-UP study. J. Card. Fail. 28, 1522\u20131530 (2022).","journal-title":"J. Card. Fail."},{"key":"3628_CR23","doi-asserted-by":"publisher","first-page":"226","DOI":"10.1177\/1474515117728624","volume":"17","author":"N Waldreus","year":"2018","unstructured":"Waldreus, N., Jaarsma, T., van der Wal, M. H. & Kato, N. P. Development and psychometric evaluation of the Thirst Distress Scale for patients with heart failure. Eur. J. Cardiovasc. Nurs. 17, 226\u2013234 (2018).","journal-title":"Eur. J. Cardiovasc. Nurs."},{"key":"3628_CR24","doi-asserted-by":"publisher","first-page":"1245","DOI":"10.1016\/S0735-1097(00)00531-3","volume":"35","author":"CP Green","year":"2000","unstructured":"Green, C. P., Porter, C. B., Bresnahan, D. R. & Spertus, J. A. Development and evaluation of the Kansas City Cardiomyopathy Questionnaire: a new health status measure for heart failure. J. Am. Coll. Cardiol. 35, 1245\u20131255 (2000).","journal-title":"J. Am. Coll. Cardiol."},{"key":"3628_CR25","doi-asserted-by":"publisher","first-page":"2492","DOI":"10.1002\/ehf2.13395","volume":"8","author":"SH Eng","year":"2021","unstructured":"Eng, S. H. et al. Thirst distress in outpatients with heart failure in a Mediterranean zone of Spain. ESC Heart Fail. 8, 2492\u20132501 (2021).","journal-title":"ESC Heart Fail."},{"key":"3628_CR26","doi-asserted-by":"publisher","first-page":"993","DOI":"10.1056\/NEJMoa1409077","volume":"371","author":"JJ McMurray","year":"2014","unstructured":"McMurray, J. J. et al. Angiotensin\u2013neprilysin inhibition versus enalapril in heart failure. N. Engl. J. Med. 371, 993\u20131004 (2014).","journal-title":"N. Engl. J. Med."},{"key":"3628_CR27","doi-asserted-by":"publisher","first-page":"1940","DOI":"10.1016\/j.jacc.2012.06.054","volume":"60","author":"PJ Veazie","year":"2012","unstructured":"Veazie, P. J. et al. Cardiac resynchronization and quality of life in patients with minimally symptomatic heart failure. J. Am. Coll. Cardiol. 60, 1940\u20131944 (2012).","journal-title":"J. Am. Coll. Cardiol."},{"key":"3628_CR28","doi-asserted-by":"publisher","first-page":"e003430","DOI":"10.1161\/CIRCHEARTFAILURE.116.003430","volume":"10","author":"EF Lewis","year":"2017","unstructured":"Lewis, E. F. et al. Health-related quality of life outcomes in PARADIGM-HF. Circ. Heart Fail. 10, e003430 (2017).","journal-title":"Circ. Heart Fail."},{"key":"3628_CR29","doi-asserted-by":"publisher","first-page":"2395","DOI":"10.1093\/eurheartj\/ehr343","volume":"32","author":"I Ekman","year":"2011","unstructured":"Ekman, I. et al. Heart rate reduction with ivabradine and health related quality of life in patients with chronic heart failure: results from the SHIFT study. Eur. Heart J. 32, 2395\u20132404 (2011).","journal-title":"Eur. Heart J."}],"container-title":["Nature Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41591-025-03628-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41591-025-03628-4","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41591-025-03628-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T11:11:05Z","timestamp":1776856265000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41591-025-03628-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,30]]},"references-count":29,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2025,6]]}},"alternative-id":["3628"],"URL":"https:\/\/doi.org\/10.1038\/s41591-025-03628-4","relation":{},"ISSN":["1078-8956","1546-170X"],"issn-type":[{"value":"1078-8956","type":"print"},{"value":"1546-170X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,30]]},"assertion":[{"value":"13 February 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 March 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 March 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"H.-P.B.-L.R. has received research grants from Innovative Health Initiative Joint Undertaking and Roche Diagnostics, received consulting fees from Astra Zeneca, Boehringer Ingelheim, Novartis, Roche Diagnostics and Vifor Pharma, received honoraria from Roche Diagnostics and participated on an Advisory Board of CeleCor Therapeutics. S.S.-v.W. has received research grants from Boehringer Ingelheim, CRL funds and ZonMW, received honoraria from Astra Zeneca, Bayer, Boehringer Ingelheim, Novartis, Novo Nordisk, Roche Diagnostics and Pfizer, and is a member of the board of the Werkgroep Cardiologisch Centra Nederland and Stichting Perfusie. P.v.d.M. has received research grants from Astra Zeneca, Pfizer, Pharma Nord, Novo Nordisk, Ionis and Vifor Pharma, honoraria from Astra Zeneca, Boehringer Ingelheim, BridgeBio, Daiichi Sankyo, Ionis, Novartis, Novo Nordisk, Pfizer, Pharma Nord, Pharmacosmos and Vifor Pharma, and participated on an Advisory Board for CorHeart. J.L.J. has received research grants from Abbott, Applied Therapeutics, Astra Zeneca, HeartFlow and Novartis, received consulting fees from Abbott, Applied Therapeutics, Astra Zeneca, Beckman, Boehringer Ingelheim, Bristol Myers, Intellia, Jana Care, Novartis, Pfizer, Merck, Roche Diagnostics and Siemens, participated on an Advisory Board for Abbott, AbbVie, Bayer, CVRx, Roche Diagnostics and Takeda, is a member of the board of American College of Cardiology and Imbria Pharmaceuticals, and has stock (options) in Imbria Pharmaceuticals and Jana Care. A.B.-G. has lectured and\/or participated in advisory boards for Abbott, Astra Zeneca, Bayer, Boehringer Ingelheim, Medtronic, Novartis, Novo Nordisk, Roche Diagnostics and Vifor Pharma. D.H.F.G. received a speaker\u2019s fee from Novartis and travel support from Astra Zeneca. R.R.J.v.K. received consulting fees from Novo Nordisk and Roche Diagnostics, honoraria from Hippocrates Academy and is a fiduciary member of the ESC working group on Peripheral Artery and Aortic Disease. The other authors declare no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}