Circulation. Heart failure
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Randomized Controlled Trial Multicenter Study
Hypochloremia, Diuretic Resistance, and Outcome in Patients With Acute Heart Failure.
Chloride plays a role in renal salt sensing, neurohormonal activation, and regulation of diuretic targets, and hypochloremia predicts mortality in acute heart failure (AHF). AHF therapies, such as diuretics, alter chloride homeostasis. We studied the association between (changes in) chloride levels and diuretic responsiveness, decongestion, and mortality in patients with AHF. ⋯ URL: http://www.clinicaltrials.gov. Unique identifier: NCT00354458.
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Randomized Controlled Trial Multicenter Study Comparative Study
Differential Response to Low-Dose Dopamine or Low-Dose Nesiritide in Acute Heart Failure With Reduced or Preserved Ejection Fraction: Results From the ROSE AHF Trial (Renal Optimization Strategies Evaluation in Acute Heart Failure).
The ROSE AHF trial (Renal Optimization Strategies Evaluation in Acute Heart Failure) found that when compared with placebo, neither low-dose dopamine (2 µg/kg per minute) nor low-dose nesiritide (0.005 μg/kg per minute without bolus) enhanced decongestion or preserved renal function in AHF patients with renal dysfunction. However, there may be differential responses to vasoactive agents in AHF patients with reduced versus preserved ejection fraction (EF). This post hoc analysis examined potential interaction between treatment effect and EF (EF ≤40% versus >40%) on the ROSE AHF end points. ⋯ URL: http://www.clinicaltrials.gov. Unique identifier: NCT01132846.
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Clinical Trial Observational Study
Hypochloremia and Diuretic Resistance in Heart Failure: Mechanistic Insights.
Recent epidemiological studies have implicated chloride, rather than sodium, as the driver of poor survival previously attributed to hyponatremia in heart failure. Accumulating basic science evidence has identified chloride as a critical factor in renal salt sensing. Our goal was to probe the physiology bridging this basic and epidemiological literature. ⋯ URL: http://www.clinicaltrials.gov. Unique identifier: NCT02031354.