Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • News & Views
  • Published:

Heart failure

Furosemide—to DOSE or not to DOSE, that is the question

In the Diuretic Optimization Strategies Evaluation (DOSE), the vexing issue of optimal administration of furosemide in patients with acute decompensated heart failure was tackled. In addition to the trial providing results that are clinically relevant, it also provides a model for future drug trials by addressing parameters such as dose, method of delivery, and duration of therapy.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

References

  1. Felker, G. M. et al. for the NHLBI Heart Failure Clinical Research Network. Diuretic strategies in patients with acute decompensated heart failure. N. Engl. J. M ed. 364, 797–805 (2011).

    Article  CAS  Google Scholar 

  2. Copeland, J. G., Campbell, D. W., Plachetka, J. R., Salomon, N. W. & Larson, D. F. Diuresis with continuous infusion of furosemide after cardiac surgery. Am. J. Surg. 146, 796–799 (1983).

    Article  CAS  Google Scholar 

  3. Rudy, D. W., Voelker, J. R., Greene, P. K., Esparaza, F. A. & Brater, D. C. Loop diuretics for chronic renal insufficiency: a continuous infusion is more efficacious than bolus therapy. Ann. Intern. Med. 115, 360–366 (1991).

    Article  CAS  Google Scholar 

  4. Testani, J. M., Chen, J., McCauley, B. D., Kimmel, S. E. & Shannon, R. P. Potential effects of aggressive decongestion during the treatment of decompensated heart failure on renal function and survival. Circulation 122, 265–272 (2010).

    Article  Google Scholar 

  5. McCurley, J. M. et al. Furosemide and the progression of left ventricular dysfunction in experimental heart failure. J. Am. Coll. Cardiol. 44, 1301–1307 (2004).

    Article  CAS  Google Scholar 

  6. Domanski, M. et al. Diuretic use, progressive heart failure, and death in patients in the studies of left ventricular dysfunction (SOLVD). J. Am. Coll. Cardiol. 42, 705–708 (2003).

    Article  CAS  Google Scholar 

  7. Chen, H. H., Redfield, M. M., Nordstrom, L. J., Cataliotti, A. & Burnett, J. C., Jr. Angiotensin II AT1 receptor antagonism prevents detrimental renal actions of acute diuretic therapy in human heart failure. Am. J. Physiol. 284, F1115–F1119 (2003).

    CAS  Google Scholar 

  8. Francis, G. S. et al. Acute vasoconstrictor response to intravenous furosemide in patients with chronic congestive heart failure. Activation of the neurohumoral axis. Ann. Intern. Med. 103, 1–6 (1985).

    Article  CAS  Google Scholar 

  9. Fonarow, G. C. Comparative effectiveness of diuretic regimens. N. Engl. J. Med. 364, 877–878 (2011).

    Article  CAS  Google Scholar 

  10. deFilippi, C. R. et al. Association of serial measures of cardiac troponin T using a sensitive assay with incidence heart failure and cardiovascular mortality in older adults. JAMA 304, 2494–2502 (2010).

    Article  CAS  Google Scholar 

Download references

Acknowledgements

This work was supported by grants from the National Institute of Health (RO1 HL36634 and PO1 HL76611) and the Mayo Foundation.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Lisa C. Costello-Boerrigter.

Ethics declarations

Competing interests

J. C. Burnett is Chair of the Scientific Advisory Board for Nile Therapeutics. L. C. Costello-Boerrigter declares no competing interests.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Costello-Boerrigter, L., Burnett, J. Furosemide—to DOSE or not to DOSE, that is the question. Nat Rev Cardiol 8, 365–366 (2011). https://doi.org/10.1038/nrcardio.2011.74

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/nrcardio.2011.74

Search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing