Six-Month Predictive Value of Diuretic Resistance Formulas in Discharged Heart Failure Patients after an Acute Decompensation

The diuretic response has been shown to be a robust independent marker of cardiovascular outcomes in acute heart failure patients. The objectives of this clinical research are to analyze two different formulas (diuretic response (DR) or response to diuretic (R-to-D)) in predicting 6-month clinical outcomes. Consecutive patients discharged alive after an acute decompensated heart failure (ADHF) were enrolled. All patients underwent N-terminal-pro hormone BNP (NT-proBNP) and an echocardiogram together with DR and R-to-D calculation during diuretic administration. Death by any cause, cardiac transplantation and worsening heart failure (HF) requiring readmission to hospital were considered cardiovascular events. 263 patients (62% male, age 78 years) were analyzed at 6-month follow-up. During the follow-up 58 (22.05%) events were scheduled. Patients who experienced CV-event had a worse renal function ( = 0.001), a higher NT-proBNP ( = 0.001), a lower left ventricular ejection fraction ( = 0.01), DR ( = 0.02) and R-to-D ( = 0.03). Spearman rho's correlation coefficient showed a strong direct correlation between DR and R to D in all patients (r = 0.93; < 0.001) and both in heart failure with reduced ejection fraction (HFrEF) (r = 0.94; < 0.001) and HF preserved ejection fraction (HFpEF) (r = 0.91; < 0.001). At multivariate analysis, a value of R-to-D