Changes in Estimating Echocardiography Pulmonary Capillary Wedge Pressure After Hypersaline Plus Furosemide Versus Furosemide Alone in Decompensated Heart Failure

Abstract Background The aim of the study was to verify the effects of hypertonic saline solution (HSS) plus a high furosemide dose and light restriction of sodium intake compared with a high-dose infusion of furosemide alone on pulmonary capillary wedge pressure (PCWP), as determined by Doppler echocardiography and tissue Doppler imaging in patients suffering from decompensated heart failure. Methods and Results Consecutive patients in New York Heart Association functional class IV, unresponsive to oral high doses of furosemide up to 250–500 mg/d and/or combinations of diuretics, with ejection fraction Conclusions Our data show that the combination of high diuretic dose and HSS infusion plus light restriction in dietary sodium intake determine a more rapid and significant hemodynamic stabilization through the improvement of echo-PCWP, BNP levels, and BIA parameters than the group treated without HSS.