{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T16:15:51Z","timestamp":1773936951629,"version":"3.50.1"},"reference-count":46,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,3,17]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Loop diuretics are used to solve congestion in acute heart failure. However, a clear indication about the best infusion modality, dose, and duration of the treatment has not yet been established. In this analysis of the DIUR\u2010AHF (Different Loop Diuretic Dosing and Administration in Acute Heart Failure) study, we aimed to investigate the effects of different diuretic administration modalities (ie, intermittent versus continuous furosemide infusion) and dose (high dose [HD] versus low dose) on congestion, renal function, and outcome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">Patients received intermittent or continuous intravenous loop diuretics infusion combined as a 1:1 ratio for a period of 72 to 120 hours. HD was defined as a high loop diuretic dose &gt;120 mg\/d. Clinical outcome was evaluated in terms of death or heart failure rehospitalization over a 6\u2010month follow\u2010up period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      A total of 370 patients with AHF were included in this analysis, 189 treated with continuous intravenous loop diuretics infusion and 181 with intermittent intravenous loop diuretics infusion. At baseline, the continuous intravenous loop diuretic infusion group showed increased median values of blood urea (\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.010) and creatinine (\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.017). Dividing our sample according to loop diuretic dosage, the HD group revealed similar congestion and weight loss compared with the low\u2010dose group; however, the HD group showed a reduced diuretic efficiency (\u22120.13 [\u22120.22 to \u22120.07] versus \u22120.32 [\u22120.59 to \u22120.20] kg\/d;\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001) and an increased rate of adverse event occurrence (55% versus 20%;\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001). Multivariable analysis showed the association between HD treatment and poor postdischarge outcome (hazard ratio, 1.95 [95% CI, 1.23\u20133.10];\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.005).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">An HD of loop diuretics infusion revealed an increased risk for adverse events together with reduced diuretic response. Our results extend previous findings revealing the association between HD diuretics and prognosis in patients with chronic HF. Additional studies may confer loop diuretic response in relation to the other decongestive treatments.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.045911","type":"journal-article","created":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T10:33:30Z","timestamp":1773138810000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Continuous Versus Intermittent Loop Diuretics Step\u2010by\u2010Step Protocol in Acute Heart Failure (DIUR\u2010AHF): A\u00a0Propensity\u2010Matched Analysis"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2841-1429","authenticated-orcid":false,"given":"Gaetano","family":"Ruocco","sequence":"first","affiliation":[{"name":"Maastrict University","place":["Maastricht, Netherlands"]},{"name":"\u201cI. Veris Delli Ponti Hospital,\u201d ASL Lecce","place":["Scorrano, Italy"]}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2352-2103","authenticated-orcid":false,"given":"Andrea","family":"Salzano","sequence":"additional","affiliation":[{"name":"\u201cFederico II\u201d University","place":["Naples, Italy"]},{"name":"Interdepartmental Center for Gender Medicine Research \u201cGENESIS\u201d","place":["Naples, Italy"]},{"name":"AORN A Cardarelli","place":["Naples, Italy"]}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6675-4540","authenticated-orcid":false,"given":"Sara","family":"Franceschi","sequence":"additional","affiliation":[{"name":"University of Siena","place":["Italy"]}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1777-2045","authenticated-orcid":false,"given":"Roberto","family":"Lorusso","sequence":"additional","affiliation":[{"name":"Maastrict University","place":["Maastricht, Netherlands"]},{"name":"Maastricht University Medical Centre","place":["Maastrict, Netherlands"]}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-1346-5426","authenticated-orcid":false,"given":"Filippo","family":"Pirrotta","sequence":"additional","affiliation":[{"name":"Le Scotte Hospital, University of Siena","place":["Siena, Italy"]}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3073-2865","authenticated-orcid":false,"given":"Andrea","family":"Stefanini","sequence":"additional","affiliation":[{"name":"Le Scotte Hospital, University of Siena","place":["Siena, Italy"]},{"name":"Clinical Cardiology Unit, Cardio\u2010Thoracic and Vascular Department Le Scotte Hospital","place":["Siena, Italy"]}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-8294-3425","authenticated-orcid":false,"given":"Antonio","family":"Pagliaro","sequence":"additional","affiliation":[{"name":"Clinical Cardiology Unit, Cardio\u2010Thoracic and Vascular Department Le Scotte Hospital","place":["Siena, Italy"]}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6211-4482","authenticated-orcid":false,"given":"Paolo","family":"Severino","sequence":"additional","affiliation":[{"name":"Sapienza University of Rome","place":["Rome, Italy"]}]},{"given":"Andrea","family":"D\u2019Amato","sequence":"additional","affiliation":[{"name":"Sapienza University of Rome","place":["Rome, Italy"]}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3540-4983","authenticated-orcid":false,"given":"Carmine D.","family":"Vizza","sequence":"additional","affiliation":[{"name":"Sapienza University of Rome","place":["Rome, Italy"]}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-8845-7010","authenticated-orcid":false,"given":"Giulia","family":"Crisci","sequence":"additional","affiliation":[{"name":"University of Milano School of Medicine, San Paolo Hospital","place":["Milan, Italy"]},{"name":"Jessa Hospital","place":["Hasselt, Belgium"]},{"name":"University of Hasselt","place":["Hasselt, 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