Heart failure & cardiomyopathiesSecondary analysis
Salt Repletion and Diuretic Response: The Role of Serum Chloride. A Post-hoc Analysis of the SALT-HF Trial on Furosemide and Hypertonic Saline Solution Administration in Ambulatory Patients with Worsening Heart Failure
- Post-hoc analysis of the SALT-HF randomised trial
- double-blind
Authors' conclusion
In ambulatory patients with WHF and hypochloraemia, adding HSS to furosemide may improve short-term natriuretic response and outcomes.
Study context
- Population
- Ambulatory patients with worsening HF
- Participants
- 148 patients
- Comparison
- Hypertonic saline solution (HSS) plus furosemide vs intravenous (IV) furosemide
- Primary endpoint
- 3-h urinary sodium excretion and diuresis, 7-day congestion score and 30-day adverse events according to chloride levels
Primary result
As reported in the abstract
3-h natriuresis by chloride level · 3 h
Between-treatment differential natriuretic effect by chloride level
pinteraction = 0.008
Lower natriuretic response with hypochloraemia
p < 0.05
Further findings
Hypochloraemia (serum chloride <96 mmol/L) at baseline · mean baseline
- Hypochloraemic patients, balanced between groups
- 16 (10.8%)
- Mean baseline serum chloride (mmol/L)
- 100 ± 4
7-day clinical congestion score and 30-day HF events
- Similar heterogeneous results, benefit with HSS at lower chloride levels
Original publication
Salt Repletion and Diuretic Response: The Role of Serum Chloride. A Post-hoc Analysis of the SALT-HF Trial on Furosemide and Hypertonic Saline Solution Administration in Ambulatory Patients with Worsening Heart Failure. Eur J Heart Fail. Published 11 February 2025. doi:10.1002/ejhf.3597
Summarised from the published abstract; every number is checked against it