If a patient does not require treatment with loop diuretics, do they really have heart failure?
This article relates to:
-
Utility of loop diuretics as a marker of risk in clinical trials of heart failure with preserved ejection fraction: Analysis from the Swedish Heart Failure Registry
- Fouad Chouairi,
- Marat Fudim,
- Gianluigi Savarese,
- Barna Szabo,
- Ulf Dahlström,
- Camilla Hage,
- Federica Guidetti,
- Lina Benson,
- Lars H. Lund,
- Volume 27Issue 6European Journal of Heart Failure
- pages: 972-978
- First Published online: January 23, 2025
Corresponding Author
John G.F. Cleland
British Heart Foundation Cardiovascular Research Centre, School of Cardiovascular & Metabolic Health, University of Glasgow, Glasgow, UK
Corresponding author. British Heart Foundation Cardiovascular Research Centre, School of Cardiovascular & Metabolic Health, University of Glasgow, 126 University Place, Glasgow G12 8TA, Lanarkshire, UK. Email: [email protected]
Search for more papers by this authorJocelyn Friday
School of Health & Wellbeing, University of Glasgow, Glasgow, UK
Search for more papers by this authorAntonio Iaconelli
British Heart Foundation Cardiovascular Research Centre, School of Cardiovascular & Metabolic Health, University of Glasgow, Glasgow, UK
Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
Search for more papers by this authorNarinder Kaur
British Heart Foundation Cardiovascular Research Centre, School of Cardiovascular & Metabolic Health, University of Glasgow, Glasgow, UK
Search for more papers by this authorPierpaolo Pellicori
British Heart Foundation Cardiovascular Research Centre, School of Cardiovascular & Metabolic Health, University of Glasgow, Glasgow, UK
Search for more papers by this authorCorresponding Author
John G.F. Cleland
British Heart Foundation Cardiovascular Research Centre, School of Cardiovascular & Metabolic Health, University of Glasgow, Glasgow, UK
Corresponding author. British Heart Foundation Cardiovascular Research Centre, School of Cardiovascular & Metabolic Health, University of Glasgow, 126 University Place, Glasgow G12 8TA, Lanarkshire, UK. Email: [email protected]
Search for more papers by this authorJocelyn Friday
School of Health & Wellbeing, University of Glasgow, Glasgow, UK
Search for more papers by this authorAntonio Iaconelli
British Heart Foundation Cardiovascular Research Centre, School of Cardiovascular & Metabolic Health, University of Glasgow, Glasgow, UK
Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
Search for more papers by this authorNarinder Kaur
British Heart Foundation Cardiovascular Research Centre, School of Cardiovascular & Metabolic Health, University of Glasgow, Glasgow, UK
Search for more papers by this authorPierpaolo Pellicori
British Heart Foundation Cardiovascular Research Centre, School of Cardiovascular & Metabolic Health, University of Glasgow, Glasgow, UK
Search for more papers by this authorThe opinions expressed in this article are not necessarily those of the Editors of the European Journal of Heart Failure or of the European Society of Cardiology. doi: 10.1002/ejhf.3578.
References
- 1Cleland JG, Tavazzi L, Daubert JC, Tageldien A, Freemantle N. Cardiac resynchronization therapy: Are modern myths preventing appropriate use? J Am Coll Cardiol 2009; 53: 608–611. https://doi.org/10.1016/j.jacc.2008.10.040
- 2Cleland JGF. Nature and magnitude of the benefits of dapagliflozin and empagliflozin for heart failure. Circulation 2024; 149: 839–842. https://doi.org/10.1161/CIRCULATIONAHA.123.068089
- 3Chouairi F, Fudim M, Savarese G, Szabo B, Dahlstrom U, Hage C, et al. Utility of loop diuretics as a marker of risk in clinical trials of heart failure with preserved ejection fraction: Analysis from the Swedish Heart Failure Registry. Eur J Heart Fail 2025; 27: 972–978. https://doi.org/10.1002/ejhf.3578
- 4Cleland JGF, Pfeffer MA, Clark AL, Januzzi JL, McMurray JJV, Mueller C, et al. The struggle towards a universal definition of heart failure – how to proceed? Eur Heart J 2021; 42: 2331–2343. https://doi.org/10.1093/eurheartj/ehab082
- 5Pellicori P, Cleland JG, Zhang J, Kallvikbacka-Bennett A, Urbinati A, Shah P, et al. Cardiac dysfunction, congestion and loop diuretics: Their relationship to prognosis in heart failure. Cardiovasc Drugs Ther 2016; 30: 599–609. https://doi.org/10.1007/s10557-016-6697-7
- 6Coiro S, Girerd N, McMurray JJV, Pitt B, Swedberg K, Van Veldhuisen DJ, et al. Diuretic therapy as prognostic enrichment factor for clinical trials in patients with heart failure with reduced ejection fraction. Clin Res Cardiol 2021; 110: 1308–1320. https://doi.org/10.1007/s00392-021-01851-w
- 7Jackson AM, Dewan P, Anand IS, Belohlavek J, Bengtsson O, de Boer RA, et al. Dapagliflozin and diuretic use in patients with heart failure and reduced ejection fraction in DAPA-HF. Circulation 2020; 142: 1040–1054. https://doi.org/10.1161/CIRCULATIONAHA.120.047077
- 8Pellicori P, Shah P, Cuthbert J, Urbinati A, Zhang J, Kallvikbacka-Bennett A, et al. Prevalence, pattern and clinical relevance of ultrasound indices of congestion in outpatients with heart failure. Eur J Heart Fail 2019; 21: 904–916. https://doi.org/10.1002/ejhf.1383
- 9Friday JM, Cleland JGF, Pellicori P, Wolters MK, McMurray JJV, Jhund PS, et al. Loop diuretic therapy with or without heart failure: Impact on prognosis. Eur Heart J 2024; 45: 3837–3849. https://doi.org/10.1093/eurheartj/ehae345
- 10McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Bohm M, et al. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: Developed by the Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). With the special contribution of the Heart Failure Association (HFA) of the ESC. Eur J Heart Fail 2022; 24: 4–131. https://doi.org/10.1002/ejhf.2333
- 11McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Bohm M, et al. 2023 Focused Update of the 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: Developed by the task force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). With the special contribution of the Heart Failure Association (HFA) of the ESC. Eur J Heart Fail 2024; 26: 5–17. https://doi.org/10.1002/ejhf.3024
- 12Cleland JGF, Erdmann E, Ferrari R, Hess OM, Poole Wilson PA, Remme WJ, et al. Guidelines for the diagnosis of heart failure. The Task Force on Heart Failure of the European Society of Cardiology. Eur Heart J 1995; 16: 741–751.
- 13Pellicori P, Fitchett D, Kosiborod MN, Ofstad AP, Seman L, Zinman B, et al. Use of diuretics and outcomes in patients with type 2 diabetes: Findings from the EMPA-REG OUTCOME trial. Eur J Heart Fail 2021; 23: 1085–1093. https://doi.org/10.1002/ejhf.2220
- 14McGrady M, Reid CM, Shiel L, Wolfe R, Boffa U, Liew D, et al. N-terminal B-type natriuretic peptide and the association with left ventricular diastolic function in a population at high risk of incident heart failure: Results of the SCReening Evaluationof the Evolution of New-Heart Failure Study (SCREEN-HF). Eur J Heart Fail 2013; 15: 573–580. https://doi.org/10.1093/eurjhf/hft001
- 15Bottle A, Kim D, Aylin P, Cowie MR, Majeed A, Hayhoe B. Routes to diagnosis of heart failure: Observational study using linked data in England. Heart 2018; 104: 600–605. https://doi.org/10.1136/heartjnl-2017-312183
Citing Literature
