Evidence map›Paper›PMID 40660874›Full record

Trial reportESC heart failure2025

Efficacy of ambulatory intravenous diuresis for chronic heart failure patients: Insights from the DEA-HF trial.

Amit Gruber, Aharon Ronnie Abbo, Ina Volis, Doron Aronson, Nicolas Girerd, Søren Lund Kristensen, Robert Zukermann, Natalia Alberkant, Elena Sitnitsky, Anton Kruger and 5 more

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in ESC heart failure, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing 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

3 citing papers in PubMed.

  1. Trial
  2. Trial
  3. Article
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

15 authors.

Amit GruberFrom the Heart Failure Unit, Department of Cardiology, Rambam Health Care Campus, Haifa, Israel.
Aharon Ronnie AbboFrom the Heart Failure Unit, Department of Cardiology, Rambam Health Care Campus, Haifa, Israel.
Ina VolisFrom the Heart Failure Unit, Department of Cardiology, Rambam Health Care Campus, Haifa, Israel.
Doron AronsonFrom the Heart Failure Unit, Department of Cardiology, Rambam Health Care Campus, Haifa, Israel.
Nicolas GirerdUniversité de Lorraine, INSERM, Centre d'Investigations Cliniques-Plurithématique 1433, CHRU Nancy, INSERM U1116, CHRU, F-CRIN INI-CRCT (Cardiovascular and Renal Clinical Trialists), Nancy, France.
Søren Lund KristensenDepartment of Cardiology, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark.
Robert ZukermannFrom the Heart Failure Unit, Department of Cardiology, Rambam Health Care Campus, Haifa, Israel.
Natalia AlberkantFrom the Heart Failure Unit, Department of Cardiology, Rambam Health Care Campus, Haifa, Israel.
Elena SitnitskyFrom the Heart Failure Unit, Department of Cardiology, Rambam Health Care Campus, Haifa, Israel.
Anton KrugerFrom the Heart Failure Unit, Department of Cardiology, Rambam Health Care Campus, Haifa, Israel.
Polina KhasisFrom the Heart Failure Unit, Department of Cardiology, Rambam Health Care Campus, Haifa, Israel.
Evgeny BravoFrom the Heart Failure Unit, Department of Cardiology, Rambam Health Care Campus, Haifa, Israel.
Boaz EladFrom the Heart Failure Unit, Department of Cardiology, Rambam Health Care Campus, Haifa, Israel.
Ludmila Helmer LevinFrom the Heart Failure Unit, Department of Cardiology, Rambam Health Care Campus, Haifa, Israel.
Oren CaspiFrom the Heart Failure Unit, Department of Cardiology, Rambam Health Care Campus, Haifa, Israel.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsOral diuretic treatment has limited efficacy in managing chronic heart failure (HF) patients. Novel strategies are needed to manage patients with refractory congestion despite optimal HF therapy and high-dose oral diuretic treatment. In the present study, we prospectively quantified the efficacy and safety of an ambulatory, weekly, high-dose parenteral diuresis strategy. METHODS AND

resultsData from the prospective, randomized, cross-over controlled study for comparisons of diuresis efficacy in HF patients (DEA-HF) were analysed. Chronic HF patients with congestion despite guideline-directed medical therapy were enrolled to receive three high-intensity diuretic regimens, once a week, in a randomized order: intravenous (IV) furosemide 250 mg; IV furosemide 250 mg + oral metolazone 5 mg; and IV furosemide 250 mg + IV acetazolamide 500 mg. The primary outcome compared the total sodium excretion following each diuretic regimen. Here, all regimens were pooled to assess the effect of weekly intensive diuresis approach on congestion parameters. The study population included 42 patients, 40% females, with a mean age of 72 ± 9 years. Following three consecutive weekly treatments, the mean body weight was decreased from 85.5 kg [95% confidence interval (CI): 79.7-91.2] to 83.1 kg (95% CI: 77.4-88.9. P = 0.0005), accompanied by a significant decrease in congestion score, N-terminal-pro-brain natriuretic peptide levels and lung ultrasound B-line count. Serum creatinine mildly but significantly increased from 1.81 mg/dL (95% CI: 1.62-2.01) to 2.01 mg/dL (95% CI: 1.81-2.21. P < 0.001), and no hospitalizations due to acute kidney injury occurred.

conclusionsIn patients with congestion-refractory HF, an ambulatory strategy utilizing high-intensity weekly IV diuretic therapy achieved effective decongestion without major safety concerns. This escalated strategy may improve clinical outcomes and prevent hospitalizations of chronic HF patients who require diuresis intensification.

Indexed as

Ambulatory CareDiuresisFurosemideHeart FailureAcetazolamideAdministration, IntravenousAgedChronic DiseaseCross-Over StudiesDiureticsDose-Response Relationship, DrugFemaleFollow-Up StudiesHumansInfusions, IntravenousMaleAcetazolamideDiureticsFurosemideMetolazonecongestionday‐carediureticsheart failure

Identifiers

PMID40660874
PMCPMC12450800

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

None linked

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.