Evidence map›Paper›PMID 26280875›Full record

ArticleClinical research in cardiology : official journal of the German Cardiac Society2016

A combined clinical and biomarker approach to predict diuretic response in acute heart failure.

Jozine M ter Maaten, Mattia A E Valente, Marco Metra, Noemi Bruno, Christopher M O'Connor, Piotr Ponikowski, John R Teerlink, Gad Cotter, Beth Davison, John G Cleland and 7 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Clinical research in cardiology : official journal of the German Cardiac Society, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.

0numbers the graph read from it
0cells of the map it votes in
21citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

21 citing papers in PubMed.

  1. Trial
  2. Spot urinary sodium in acute decompensation of advanced heart failure and dilutional hyponatremia: insights from DRAIN trial.Clinical research in cardiology : official journal of the German Cardiac Society · 2020
    Trial
  3. Early treatment with tolvaptan improves diuretic response in acute heart failure with renal dysfunction.Clinical research in cardiology : official journal of the German Cardiac Society · 2017
    Trial
  4. Association between route of furosemide administration and diuretic response in very preterm infants with bronchopulmonary dysplasia.Journal of perinatology : official journal of the California Perinatal Association · 2026
    Article
  5. Article
  6. Review
  7. Article
  8. Predictors of Poor Very Early Diuretic Response and Effectiveness of Early Tolvaptan in Symptomatic Acute Heart Failure.American journal of cardiovascular drugs : drugs, devices, and other interventions · 2023
    Article
  9. Review
  10. Article
  11. Review
  12. Article
  13. Article
  14. Article
  15. Article
  16. Article
  17. Article
  18. Circadian rhythm of blood cardiac troponin T concentration.Clinical research in cardiology : official journal of the German Cardiac Society · 2017
    Article
  19. Article
  20. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors.

Jozine M ter MaatenDepartment of Cardiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands.
Mattia A E ValenteDepartment of Cardiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands.
Marco MetraUniversity of Brescia, Brescia, Italy.
Noemi BrunoDepartment of Cardiovascular Sciences, "Sapienza" University of Rome, Rome, Italy.
Christopher M O'ConnorDuke University Medical Center, Durham, NC, USA.
Piotr PonikowskiClinical Military Hospital, Medical University, Wroclaw, Poland.
John R TeerlinkUniversity of California at San Francisco and San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA.
Gad CotterMomentum Research, Durham, NC, USA.
Beth DavisonMomentum Research, Durham, NC, USA.
John G ClelandUniversity of Hull, Kingston upon Hull, UK.
Michael M GivertzBrigham and Women's Hospital, Boston, MA, USA.
Daniel M BloomfieldMerck Research Laboratories, Rahway, NJ, USA.
Howard C DittrichUniversity of Iowa Carver College of Medicine Cardiovascular Research Center, Iowa City, IA, USA.
Dirk J van VeldhuisenDepartment of Cardiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands.
Hans L HillegeDepartment of Cardiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands.
Kevin DammanDepartment of Cardiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands.
Adriaan A VoorsDepartment of Cardiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands. a.a.voors@umcg.nl.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPoor diuretic response in acute heart failure is related to poor clinical outcome. The underlying mechanisms and pathophysiology behind diuretic resistance are incompletely understood. We evaluated a combined approach using clinical characteristics and biomarkers to predict diuretic response in acute heart failure (AHF). METHODS AND

resultsWe investigated explanatory and predictive models for diuretic response--weight loss at day 4 per 40 mg of furosemide--in 974 patients with AHF included in the PROTECT trial. Biomarkers, addressing multiple pathophysiological pathways, were determined at baseline and after 24 h. An explanatory baseline biomarker model of a poor diuretic response included low potassium, chloride, hemoglobin, myeloperoxidase, and high blood urea nitrogen, albumin, triglycerides, ST2 and neutrophil gelatinase-associated lipocalin (r(2) = 0.086). Diuretic response after 24 h (early diuretic response) was a strong predictor of diuretic response (β = 0.467, P < 0.001; r(2) = 0.523). Addition of diuretic response after 24 h to biomarkers and clinical characteristics significantly improved the predictive model (r(2) = 0.586, P < 0.001).

conclusionsBiomarkers indicate that diuretic unresponsiveness is associated with an atherosclerotic profile with abnormal renal function and electrolytes. However, predicting diuretic response is difficult and biomarkers have limited additive value. Patients at risk of poor diuretic response can be identified by measuring early diuretic response after 24 h.

Indexed as

Acute DiseaseAtherosclerosisBiomarkersClinical Trials, Phase III as TopicDiureticsElectrolytesFurosemideHeart FailureHumansKidney DiseasesRandomized Controlled Trials as TopicRetrospective StudiesTime FactorsTreatment OutcomeBiomarkersDiureticsElectrolytesFurosemideBiomarkersDiuretic responseHeart failurePrediction

Identifiers

PMID26280875
PMCPMC4735256

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.