{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T18:33:27Z","timestamp":1793385207186,"version":"4.5.0"},"reference-count":48,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,10,14]],"date-time":"2020-10-14T00:00:00Z","timestamp":1602633600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,10,14]],"date-time":"2020-10-14T00:00:00Z","timestamp":1602633600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Shanghai Changning District Health Commission, Specialty in Acute Heart Failure","award":["20062002"],"award-info":[{"award-number":["20062002"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Cardiovasc Disord"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n<jats:title>Background<\/jats:title>\n<jats:p>Ultrafiltration decreases total body water and improves the alveolar to arterial oxygen gradient. The aims of the study were to investigate the efficacy and safety of early ultrafiltration in acute decompensated heart failure (ADHF) patients.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>100 patients with ADHF within 24\u00a0h of admission were randomly assigned into early ultrafiltration (n\u2009=\u200940) or torasemide plus tolvaptan (n\u2009=\u200960) groups. The primary outcomes were weight loss and an increase in urine output on days 4 and 8 of treatment.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>Patients who received early ultrafiltration for 3\u00a0days achieved a greater weight loss (kg) (\u2212\u20092.94\u2009\u00b1\u20093.76 vs \u2212\u20090.64\u2009\u00b1\u20090.91, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001) and urine increase (mL) (198.00\u2009\u00b1\u2009170.70 vs 61.77\u2009\u00b1\u20094.67, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001) than the torasemide plus tolvaptan group on day 4. From days 4 to 7, patients in the early ultrafiltration group received sequential therapy of torasemide and tolvaptan. Better control of volume was reflected in a greater weight loss (\u2212\u20093.72\u2009\u00b1\u20093.81 vs \u2212\u20091.34\u2009\u00b1\u20091.32, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001) and urine increase (373.80\u2009\u00b1\u2009120.90 vs 79.5\u2009\u00b1\u200952.35, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001), greater reduction of B-type natriuretic peptide (BNP) (pg\/mL) (\u2212\u20091144\u2009\u00b1\u20091435 vs \u2212\u2009654.02\u2009\u00b1\u2009889.65, <jats:italic>P<\/jats:italic>\u2009=\u20090.037), NYHA (New York Heart Association) functional class (\u2212\u20091.45\u2009\u00b1\u20090.50 vs \u2212\u20091.17\u2009\u00b1\u20090.62, <jats:italic>P<\/jats:italic>\u2009=\u20090.018), jugular venous pulse (JVP) score (points) (\u2212\u20091.9\u2009\u00b1\u20091.13 vs \u2212\u20090.78\u2009\u00b1\u20090.69, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001), inferior vena cava (IVC) diameter (mm) (\u2212\u200915.35\u2009\u00b1\u200911.03 vs \u2212\u20094.98\u2009\u00b1\u20096.00, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001) and an increase in the dyspnea score (points) (4.08\u2009\u00b1\u20093.44 vs 2.77\u2009\u00b1\u20092.03, <jats:italic>P<\/jats:italic>\u2009=\u20090.035) in the early ultrafiltration group on day 8. No significant differences were found in the readmission and mortality rates in the 2 patient groups at the 1-month and 3-month follow-ups. Both groups had a similar stable renal profile.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Early ultrafiltration is superior to diuretics for volume overload treatment initiation of ADHF patients.<\/jats:p>\n<jats:p><jats:italic>Trial registration<\/jats:italic>\u00a0Chinese Clinical Trial Registry, ChiCTR2000030696, Registered 10 March 2020\u2014Retrospectively registered, <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.chictr.org.cn\/showproj.aspx?proj=29099\">https:\/\/www.chictr.org.cn\/showproj.aspx?proj=29099<\/jats:ext-link>.<\/jats:p>\n<\/jats:sec>","DOI":"10.1186\/s12872-020-01733-5","type":"journal-article","created":{"date-parts":[[2020,10,14]],"date-time":"2020-10-14T11:02:56Z","timestamp":1602673376000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":31,"title":["Efficacy and safety of early ultrafiltration in patients with acute decompensated heart failure with volume overload: a prospective, randomized, controlled clinical trial"],"prefix":"10.1186","volume":"20","author":[{"given":"Jingyi","family":"Hu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qianli","family":"Wan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yue","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miaomiao","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Jiang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5278-110X","authenticated-orcid":false,"given":"Fang","family":"Yuan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,10,14]]},"reference":[{"issue":"3","key":"1733_CR1","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1016\/j.recesp.2014.11.009","volume":"68","author":"D Farmakis","year":"2015","unstructured":"Farmakis D, Parissis J, Lekakis J, Filippatos G. 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Written informed consent from every participating patient was obtained.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to publish"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"447"}}