{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T02:32:11Z","timestamp":1789007531571,"version":"build-2803163510"},"reference-count":21,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","funder":[{"DOI":"10.13039\/100000050","name":"HHS | NIH | National Heart, Lung, and Blood Institute","doi-asserted-by":"crossref","award":["U01-HL125478 and U01-HL125511"],"award-info":[{"award-number":["U01-HL125478 and U01-HL125511"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000050","name":"HHS | NIH | National Heart, Lung, and Blood Institute","doi-asserted-by":"crossref","award":["R01HL148354-04 and R01HL154768-02"],"award-info":[{"award-number":["R01HL148354-04 and R01HL154768-02"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2023,7,11]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>Loop diuretics are a primary therapy for the symptomatic treatment of heart failure (HF), but whether torsemide improves patient symptoms and quality of life better than furosemide remains unknown. As prespecified secondary end points, the TRANSFORM-HF trial (Torsemide Comparison With Furosemide for Management of Heart Failure) compared the effect of torsemide versus furosemide on patient-reported outcomes among patients with HF.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>TRANSFORM-HF was an open-label, pragmatic, randomized trial of 2859 patients hospitalized for HF (regardless of ejection fraction) across 60 hospitals in the United States. Patients were randomly assigned in a 1:1 ratio to a loop diuretic strategy of torsemide or furosemide with investigator-selected dosage. This report examined effects on prespecified secondary end points, which included Kansas City Cardiomyopathy Questionnaire Clinical Summary Score (KCCQ-CSS; assessed as adjusted mean difference in change from baseline; range, 0\u2013100 with 100 indicating best health status; clinically important difference, \u22655 points) and Patient Health Questionnaire-2 (range, 0\u20136; score \u22653 supporting evaluation for depression) over 12 months.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>\n              Baseline data were available for 2787 (97.5%) patients for KCCQ-CSS and 2624 (91.8%) patients for Patient Health Questionnaire-2. Median (interquartile range) baseline KCCQ-CSS was 42 (27\u201360) in the torsemide group and 40 (24\u201359) in the furosemide group. At 12 months, there was no significant difference between torsemide and furosemide in change from baseline in KCCQ-CSS (adjusted mean difference, 0.06 [95% CI, \u20132.26 to 2.37];\n              <jats:italic>P<\/jats:italic>\n              =0.96) or the proportion of patients with Patient Health Questionnaire-2 score \u22653 (15.1% versus 13.2%:\n              <jats:italic>P<\/jats:italic>\n              =0.34). Results for KCCQ-CSS were similar at 1 month (adjusted mean difference, 1.36 [95% CI, \u20130.64 to 3.36];\n              <jats:italic>P<\/jats:italic>\n              =0.18) and 6-month follow-up (adjusted mean difference, \u20130.37 [95% CI, \u20132.52 to 1.78];\n              <jats:italic>P<\/jats:italic>\n              =0.73), and across subgroups by ejection fraction phenotype, New York Heart Association class at randomization, and loop diuretic agent before hospitalization. Irrespective of baseline KCCQ-CSS tertile, there was no significant difference between torsemide and furosemide on change in KCCQ-CSS, all-cause mortality, or all-cause hospitalization.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>Among patients discharged after hospitalization for HF, a strategy of torsemide compared with furosemide did not improve symptoms or quality of life over 12 months. The effects of torsemide and furosemide on patient-reported outcomes were similar regardless of ejection fraction, previous loop diuretic use, and baseline health status.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Registration:<\/jats:title>\n            <jats:p>\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n              ; Unique identifier: NCT03296813.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circulationaha.123.064842","type":"journal-article","created":{"date-parts":[[2023,5,22]],"date-time":"2023-05-22T13:11:32Z","timestamp":1684761092000},"page":"124-134","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":24,"title":["Effect of Torsemide Versus Furosemide on Symptoms and Quality of Life Among Patients Hospitalized for Heart Failure: The TRANSFORM-HF Randomized Clinical Trial"],"prefix":"10.1161","volume":"148","clinical-trial-number":[{"clinical-trial-number":"nct03296813","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6912-7374","authenticated-orcid":true,"given":"Stephen J.","family":"Greene","sequence":"first","affiliation":[{"name":"Duke Clinical Research Institute, Durham, NC (S.J.G., R.M.C., E.L.E., R.J.M.)."},{"name":"Division of Cardiology, Duke University School of Medicine, Durham, NC (S.J.G., T.A.D., R.J.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2245-7477","authenticated-orcid":true,"given":"Eric J.","family":"Velazquez","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, CT (E.J.V.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin J.","family":"Anstrom","sequence":"additional","affiliation":[{"name":"Gillings School of Global Public Health, University of North Carolina, Chapel Hill (K.J.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert M.","family":"Clare","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute, Durham, NC (S.J.G., R.M.C., E.L.E., R.J.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tracy A.","family":"DeWald","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Duke University School of Medicine, Durham, NC (S.J.G., T.A.D., R.J.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitchell A.","family":"Psotka","sequence":"additional","affiliation":[{"name":"Inova Heart and Vascular Institute, Falls Church, VA (M.A.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4563-1071","authenticated-orcid":true,"given":"Andrew P.","family":"Ambrosy","sequence":"additional","affiliation":[{"name":"Division of Research, Kaiser Permanente Northern California, Oakland (A.P.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8235-5045","authenticated-orcid":true,"given":"Gerin R.","family":"Stevens","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Northwell Health, Zucker School of Medicine at Hofstra\/Northwell, North Shore University Hospital, Manhasset, NY (G.R.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John J.","family":"Rommel","sequence":"additional","affiliation":[{"name":"Novant Health Heart and Vascular Institute, Wilmington, NC (J.J.R.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamas","family":"Alexy","sequence":"additional","affiliation":[{"name":"Division of Cardiology, University of Minnesota, Minneapolis (T.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fassil","family":"Ketema","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, MD (F.K., D.-Y.K., P.D.-N.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dong-Yun","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, MD (F.K., D.-Y.K., P.D.-N.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1073-641X","authenticated-orcid":true,"given":"Patrice","family":"Desvigne-Nickens","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, MD (F.K., D.-Y.K., P.D.-N.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bertram","family":"Pitt","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Cardiology, University of Michigan, Ann Arbor (B.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0216-428X","authenticated-orcid":true,"given":"Eric L.","family":"Eisenstein","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute, Durham, NC (S.J.G., R.M.C., E.L.E., R.J.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3222-1719","authenticated-orcid":true,"given":"Robert J.","family":"Mentz","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute, Durham, NC (S.J.G., R.M.C., E.L.E., R.J.M.)."},{"name":"Division of Cardiology, Duke University School of Medicine, Durham, NC (S.J.G., T.A.D., 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