A new research paper has been published in Volume 18. Aging-United States on March 26, 2026, entitled “Effects of intravenous furosemide and small doses of hypertonic saline on inflammation, remodeling markers and epigenetic signatures in patients with congestive acute decompensated heart failure (ADHF).”
First author Mario Daidone (Polyclinic University Hospital, Paolo Giaccone, University of Palermo) and corresponding author Antonino A randomized trial led by Dr. Tuttolomondo (University Hospital, Policlinico, Paolo Giaccone, University of Palermo) compared intravenous furosemide plus low-dose hypertonic saline (HSS) versus intravenous furosemide alone in patients with acute decompensated heart failure. Ejection fraction. The study enrolled 200 subjects, with 107 randomly assigned to furosemide and HSS and 93 to furosemide alone.
The authors found that patients treated with intravenous furosemide and HSS had lower increases in inflammatory and remodeling biomarkers (such as IL-6, hsTnT, sST2, galectin-3, and NT-proBNP) after saline challenge, and this intervention was associated with decreased miR181b expression compared with furosemide alone. These findings suggest that adding small amounts of hypertonic saline to loop diuretic therapy may influence both circulating biomarkers and miRNA-related epigenetic signatures in acute heart failure.
“Nevertheless, the possible effects of intravenous treatment with furosemide plus HSS on natriuretic and inflammatory markers of heart failure merit further confirmation, whereas the effects of this type of treatment on the epigenetic manifestations of the pathological mechanisms involved in left ventricular dysfunction involved in the development of AHF seem to remain unexplored.”.”
The authors note that because this is a randomized trial in a specific ADHF population, additional studies are needed to confirm the persistence of biomarker changes, define optimal patient groups, and determine whether these molecular effects translate into improved clinical outcomes. Future studies may also determine how saline strategies interact with cardiac remodeling and miRNA regulation in larger and more diverse heart failure cohorts.
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Reference magazines:
Didon, M. others. (2026) Effects of intravenous administration of furosemide and small doses of hypertonic saline on inflammation, remodeling markers and epigenetic signatures in patients with congestive acute decompensated heart failure (ADHF). aging DOI: 10.18632/Aging.206364. https://www.aging-us.com/article/206364/text
