Heart failure & cardiomyopathies
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
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
Methodological detailsdouble-blind
- Double-blind
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.
Summarised from the published abstract; every number is checked against it