Effects of intravenous furosemide plus small‐volume hypertonic saline solutions on markers of heart failure

Aims We sought to compare the effects of furosemide + hypertonic saline solution (HSS) treatment in patients with acute decompensated heart failure in comparison with furosemide alone and the response in a compensated state after an acute saline load with regard to serum levels of heart failure biomarkers. Methods and results We enrolled 141 patients with acute decompensated heart failure with reduced ejection fraction admitted to our Internal Medicine ward from March 2017 to November 2019. A total of 73 patients were randomized to treatment with i.v. high‐dose furosemide plus HSS, whereas 68 patients were randomized to i.v. high‐dose furosemide alone. Patients treated with furosemide plus HSS compared with controls treated with furosemide alone showed a comparable degree of reduction in the serum levels of interleukin (IL)‐6, soluble suppression of tumorigenicity 2 (sST2), and N‐terminal pro‐brain natriuretic peptide (NT‐proBNP) in the ‘between‐group’ analysis. Nevertheless, patients treated with high‐dose furosemide + HSS showed significantly higher absolute delta values of IL‐6 (2.3 ± 1.2 vs. 1.7 ± 0.9, P