The infographic details findings from the DEA-HF study, which was designed to evaluate the efficacy and safety of three different diuretic treatment regimens in patients with ambulatory congested heart failure (CHF). The study was conducted in a prospective, randomized, open-label, crossover format, involving 42 patients. The participants were primarily older adults with an average age of 72 years and predominantly male (60%). Most of these patients were already receiving a range of standard CHF therapies including ACE inhibitors, ARBs, ARNIs, beta blockers, and MRAs.
The treatments compared were:
- Regimen A: Intravenous (IV) Furosemide at a dose of 250 mg combined with oral Metolazone 5 mg.
- Regimen B: IV Furosemide at a dose of 250 mg alone.
- Regimen C: IV Furosemide at 250 mg plus IV Acetazolamide 500 mg.
The primary outcome measured was total sodium excretion from the body, which is a key indicator of the diuretic effect. Regimen A was found to be significantly more effective in promoting sodium excretion than the other two regimens. Specifically, total sodium excretion was 4691 mg with Regimen A, compared to 3835 mg with Regimen B (P=0.015) and 3584 mg with Regimen C (P=0.001).
Secondary outcomes included total urinary volume excretion, which follows a similar trend. Regimen A led to a urinary volume of 1.84 liters, higher than both Regimen B (1.71 liters) and Regimen C (1.58 liters), indicating a stronger diuretic effect.
The study conclusively demonstrated that in patients with ambulatory CHF, the combination of furosemide and metolazone results in significantly higher natriuresis (sodium excretion) compared to either IV furosemide alone or in combination with acetazolamide. These findings suggest that Regimen A might offer a more potent therapeutic option for enhancing fluid clearance in this patient population, potentially improving symptom management and reducing the risk of fluid overload complications in CHF patients. Source