Potential Role of Natriuretic Response to Furosemide Stress Test During Acute Heart Failure.

Aged Biomarkers / analysis Diuretics / pharmacology Exercise Test / methods Female Furosemide / pharmacology Heart Failure / physiopathology Humans Male Middle Aged Natriuresis / physiology Prospective Studies Time Factors
diuretics heart failure hospitalization natriuresis prognosis

Journal

Circulation. Heart failure
ISSN: 1941-3297
Titre abrégé: Circ Heart Fail
Pays: United States
ID NLM: 101479941

Informations de publication

Date de publication:
06 2021
Historique:
entrez: 15 6 2021
pubmed: 16 6 2021
medline: 12 11 2021
Statut: ppublish

Résumé

Poor natriuresis has been associated with a poorer response to diuretic treatment and worse prognosis in acute heart failure. Recommendations on how and when to measure urinary sodium (UNa) are lacking. We aim to evaluate UNa quantification after a furosemide stress test (FST) capacity to predict appropriate decongestion during acute heart failure hospitalization. Patients underwent an FST on day-1 of admission, and UNa was measured 2 hours after, dividing patients into low or high UNa based on the sample median value. A semiquantitative composite congestive score (CCS; 0-9) and NT pro-BNP (N-terminal pro-B-type natriuretic peptide) quantification were assessed before the FST and at day 5 after the FST. Median UNa after FST in the 65 patients included was 113 (97-122) mmol/L. At day 5, a lower proportion of patients with a low UNa reached a 30% decrease in NT-proBNP levels (21 [66%] for low UNa versus 31 [94%] for high UNa; Low natriuresis after an FST identified patients at a higher risk of an inadequate diuretic response and an inappropriate decongestion. FST-guided diuretic treatment might help to improve decongestion, shorten hospitalizations, and to reduce adverse outcomes.

Sections du résumé

BACKGROUND
Poor natriuresis has been associated with a poorer response to diuretic treatment and worse prognosis in acute heart failure. Recommendations on how and when to measure urinary sodium (UNa) are lacking. We aim to evaluate UNa quantification after a furosemide stress test (FST) capacity to predict appropriate decongestion during acute heart failure hospitalization.
METHODS
Patients underwent an FST on day-1 of admission, and UNa was measured 2 hours after, dividing patients into low or high UNa based on the sample median value. A semiquantitative composite congestive score (CCS; 0-9) and NT pro-BNP (N-terminal pro-B-type natriuretic peptide) quantification were assessed before the FST and at day 5 after the FST.
RESULTS
Median UNa after FST in the 65 patients included was 113 (97-122) mmol/L. At day 5, a lower proportion of patients with a low UNa reached a 30% decrease in NT-proBNP levels (21 [66%] for low UNa versus 31 [94%] for high UNa;
CONCLUSIONS
Low natriuresis after an FST identified patients at a higher risk of an inadequate diuretic response and an inappropriate decongestion. FST-guided diuretic treatment might help to improve decongestion, shorten hospitalizations, and to reduce adverse outcomes.

Identifiants

DOI: 10.1161/CIRCHEARTFAILURE.120.008166 PMID: 34129364
pubmed: 34129364
doi: 10.1161/CIRCHEARTFAILURE.120.008166
doi:

Substances chimiques

Biomarkers 0
Diuretics 0
Furosemide 7LXU5N7ZO5

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

e008166

Commentaires et corrections

Type : CommentIn
Type : CommentIn

Auteurs

Pedro Caravaca Pérez (P)

Servicio de Cardiología, Hospital Universitario 12 de Octubre, Madrid, Spain (P.C.P., J.N., L.M.F., Z.B.-B., J.C.L.-A., J.d.J.B., M.D.G.-C.C., P.E.S., R.S.-B., F.A.Y., J.F.D.).
Centro de Investigaciones Biomédicas En Red de enfermedades CardioVasculares (CIBERCV), Spain (P.C.P., J.N., L.M.F., J.C.L.-A., J.d.J.B., M.D.G.-C.C., P.E.S., R.S.-B., F.A.Y., J.F.D.).
Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain (P.C.P., J.N., L.M.F., D.L., Z.B.-B., J.C.L-A., J.d.J.B., M.D.G.-C.C., P.E.S., R.S.-B., F.A.Y., J.F.D.).

Jorge Nuche (J)

Servicio de Cardiología, Hospital Universitario 12 de Octubre, Madrid, Spain (P.C.P., J.N., L.M.F., Z.B.-B., J.C.L.-A., J.d.J.B., M.D.G.-C.C., P.E.S., R.S.-B., F.A.Y., J.F.D.).
Centro de Investigaciones Biomédicas En Red de enfermedades CardioVasculares (CIBERCV), Spain (P.C.P., J.N., L.M.F., J.C.L.-A., J.d.J.B., M.D.G.-C.C., P.E.S., R.S.-B., F.A.Y., J.F.D.).
Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain (J.N.).
Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain (P.C.P., J.N., L.M.F., D.L., Z.B.-B., J.C.L-A., J.d.J.B., M.D.G.-C.C., P.E.S., R.S.-B., F.A.Y., J.F.D.).

Laura Morán Fernández (L)

Servicio de Cardiología, Hospital Universitario 12 de Octubre, Madrid, Spain (P.C.P., J.N., L.M.F., Z.B.-B., J.C.L.-A., J.d.J.B., M.D.G.-C.C., P.E.S., R.S.-B., F.A.Y., J.F.D.).
Centro de Investigaciones Biomédicas En Red de enfermedades CardioVasculares (CIBERCV), Spain (P.C.P., J.N., L.M.F., J.C.L.-A., J.d.J.B., M.D.G.-C.C., P.E.S., R.S.-B., F.A.Y., J.F.D.).
Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain (P.C.P., J.N., L.M.F., D.L., Z.B.-B., J.C.L-A., J.d.J.B., M.D.G.-C.C., P.E.S., R.S.-B., F.A.Y., J.F.D.).

David Lora (D)

Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain (P.C.P., J.N., L.M.F., D.L., Z.B.-B., J.C.L-A., J.d.J.B., M.D.G.-C.C., P.E.S., R.S.-B., F.A.Y., J.F.D.).

Zorba Blázquez-Bermejo (Z)

Servicio de Cardiología, Hospital Universitario 12 de Octubre, Madrid, Spain (P.C.P., J.N., L.M.F., Z.B.-B., J.C.L.-A., J.d.J.B., M.D.G.-C.C., P.E.S., R.S.-B., F.A.Y., J.F.D.).
Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain (P.C.P., J.N., L.M.F., D.L., Z.B.-B., J.C.L-A., J.d.J.B., M.D.G.-C.C., P.E.S., R.S.-B., F.A.Y., J.F.D.).

Juan Carlos López-Azor (JC)

Servicio de Cardiología, Hospital Universitario 12 de Octubre, Madrid, Spain (P.C.P., J.N., L.M.F., Z.B.-B., J.C.L.-A., J.d.J.B., M.D.G.-C.C., P.E.S., R.S.-B., F.A.Y., J.F.D.).
Centro de Investigaciones Biomédicas En Red de enfermedades CardioVasculares (CIBERCV), Spain (P.C.P., J.N., L.M.F., J.C.L.-A., J.d.J.B., M.D.G.-C.C., P.E.S., R.S.-B., F.A.Y., J.F.D.).
Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain (P.C.P., J.N., L.M.F., D.L., Z.B.-B., J.C.L-A., J.d.J.B., M.D.G.-C.C., P.E.S., R.S.-B., F.A.Y., J.F.D.).

Javier de Juan Bagudá (J)

Servicio de Cardiología, Hospital Universitario 12 de Octubre, Madrid, Spain (P.C.P., J.N., L.M.F., Z.B.-B., J.C.L.-A., J.d.J.B., M.D.G.-C.C., P.E.S., R.S.-B., F.A.Y., J.F.D.).
Centro de Investigaciones Biomédicas En Red de enfermedades CardioVasculares (CIBERCV), Spain (P.C.P., J.N., L.M.F., J.C.L.-A., J.d.J.B., M.D.G.-C.C., P.E.S., R.S.-B., F.A.Y., J.F.D.).
Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain (P.C.P., J.N., L.M.F., D.L., Z.B.-B., J.C.L-A., J.d.J.B., M.D.G.-C.C., P.E.S., R.S.-B., F.A.Y., J.F.D.).

María Dolores García-Cosío Carmena (MD)

Servicio de Cardiología, Hospital Universitario 12 de Octubre, Madrid, Spain (P.C.P., J.N., L.M.F., Z.B.-B., J.C.L.-A., J.d.J.B., M.D.G.-C.C., P.E.S., R.S.-B., F.A.Y., J.F.D.).
Centro de Investigaciones Biomédicas En Red de enfermedades CardioVasculares (CIBERCV), Spain (P.C.P., J.N., L.M.F., J.C.L.-A., J.d.J.B., M.D.G.-C.C., P.E.S., R.S.-B., F.A.Y., J.F.D.).
Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain (P.C.P., J.N., L.M.F., D.L., Z.B.-B., J.C.L-A., J.d.J.B., M.D.G.-C.C., P.E.S., R.S.-B., F.A.Y., J.F.D.).

Pilar Escribano Subías (P)

Servicio de Cardiología, Hospital Universitario 12 de Octubre, Madrid, Spain (P.C.P., J.N., L.M.F., Z.B.-B., J.C.L.-A., J.d.J.B., M.D.G.-C.C., P.E.S., R.S.-B., F.A.Y., J.F.D.).
Centro de Investigaciones Biomédicas En Red de enfermedades CardioVasculares (CIBERCV), Spain (P.C.P., J.N., L.M.F., J.C.L.-A., J.d.J.B., M.D.G.-C.C., P.E.S., R.S.-B., F.A.Y., J.F.D.).
Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain (P.C.P., J.N., L.M.F., D.L., Z.B.-B., J.C.L-A., J.d.J.B., M.D.G.-C.C., P.E.S., R.S.-B., F.A.Y., J.F.D.).
Facultad de Medicina, Universidad Complutense de Madrid, Spain (P.E.S., R.S.-B., F.A.Y., J.F.D.).

Rafael Salguero-Bodes (R)

Servicio de Cardiología, Hospital Universitario 12 de Octubre, Madrid, Spain (P.C.P., J.N., L.M.F., Z.B.-B., J.C.L.-A., J.d.J.B., M.D.G.-C.C., P.E.S., R.S.-B., F.A.Y., J.F.D.).
Centro de Investigaciones Biomédicas En Red de enfermedades CardioVasculares (CIBERCV), Spain (P.C.P., J.N., L.M.F., J.C.L.-A., J.d.J.B., M.D.G.-C.C., P.E.S., R.S.-B., F.A.Y., J.F.D.).
Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain (P.C.P., J.N., L.M.F., D.L., Z.B.-B., J.C.L-A., J.d.J.B., M.D.G.-C.C., P.E.S., R.S.-B., F.A.Y., J.F.D.).
Facultad de Medicina, Universidad Complutense de Madrid, Spain (P.E.S., R.S.-B., F.A.Y., J.F.D.).

Fernando Arribas Ynsaurriaga (F)

Servicio de Cardiología, Hospital Universitario 12 de Octubre, Madrid, Spain (P.C.P., J.N., L.M.F., Z.B.-B., J.C.L.-A., J.d.J.B., M.D.G.-C.C., P.E.S., R.S.-B., F.A.Y., J.F.D.).
Centro de Investigaciones Biomédicas En Red de enfermedades CardioVasculares (CIBERCV), Spain (P.C.P., J.N., L.M.F., J.C.L.-A., J.d.J.B., M.D.G.-C.C., P.E.S., R.S.-B., F.A.Y., J.F.D.).
Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain (P.C.P., J.N., L.M.F., D.L., Z.B.-B., J.C.L-A., J.d.J.B., M.D.G.-C.C., P.E.S., R.S.-B., F.A.Y., J.F.D.).
Facultad de Medicina, Universidad Complutense de Madrid, Spain (P.E.S., R.S.-B., F.A.Y., J.F.D.).

Juan F Delgado (JF)

Servicio de Cardiología, Hospital Universitario 12 de Octubre, Madrid, Spain (P.C.P., J.N., L.M.F., Z.B.-B., J.C.L.-A., J.d.J.B., M.D.G.-C.C., P.E.S., R.S.-B., F.A.Y., J.F.D.).
Centro de Investigaciones Biomédicas En Red de enfermedades CardioVasculares (CIBERCV), Spain (P.C.P., J.N., L.M.F., J.C.L.-A., J.d.J.B., M.D.G.-C.C., P.E.S., R.S.-B., F.A.Y., J.F.D.).
Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain (P.C.P., J.N., L.M.F., D.L., Z.B.-B., J.C.L-A., J.d.J.B., M.D.G.-C.C., P.E.S., R.S.-B., F.A.Y., J.F.D.).
Facultad de Medicina, Universidad Complutense de Madrid, Spain (P.E.S., R.S.-B., F.A.Y., J.F.D.).

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Classifications MeSH

questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Sujet âgé › Potential Role of Natriuretic Response to...
questionsmedicales.fr › Facteurs biologiques › Marqueurs biologiques › Potential Role of Natriuretic Response to...
questionsmedicales.fr › Actions chimiques et utilisations › Actions pharmacologiques › Effets physiologiques des médicaments › Diurétiques › Potential Role of Natriuretic Response to...
questionsmedicales.fr › Techniques d'investigation › Ergométrie › Épreuve d'effort › Potential Role of Natriuretic Response to...
questionsmedicales.fr › Composés chimiques organiques › Composés du soufre › Sulfones › Sulfonamides › Sulfamides › Furosémide › Potential Role of Natriuretic Response to...
questionsmedicales.fr › Maladies cardiovasculaires › Cardiopathies › Défaillance cardiaque › Potential Role of Natriuretic Response to...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Potential Role of Natriuretic Response to...
questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Adulte d'âge moyen › Potential Role of Natriuretic Response to...
questionsmedicales.fr › Phénomènes physiologiques des appareils urinaire et reproducteur › Phénomènes physiologiques des voies urinaires › Diurèse › Natriurèse › Potential Role of Natriuretic Response to...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études prospectives › Potential Role of Natriuretic Response to...
questionsmedicales.fr › Phénomènes physiques › Temps › Facteurs temps › Potential Role of Natriuretic Response to...