Water and sodium in heart failure: a spotlight on congestion
Authors: Mihai Gheorghiade
Gaspare Parrinello
Stephen J Greene
Luna Gargani
Anju Nohria
Joseph Vincent Bonventre
Daniele Torres
Michael Alderman
Lynne Warner Stevenson
Muthiah Vaduganathan
Pietro Di Pasquale
Gregg C Fonarow
Salvatore Paterna
Javed Butler
Journal: Heart Failure Reviews (2015)
Discipline: CLINICAL MEDICINE
Keywords: heart failure; hospitalization; death; congestion; therapy
Affiliations: Biomedical Department of Internal and Specialty Medicine (Di.Bi.M.I.S.), A.O.U.P "Paolo Giaccone", University of Palermo, Piazza delle Cliniche 2, 90127, Palermo, Italy, .

Abstract:  Despite all available therapies, the rates of hospitalization and death from heart failure (HF) remain unacceptably high. The most common reasons for hospital admission are symptoms related to congestion. During hospitalization, most patients respond well to standard therapy and are discharged with significantly improved symptoms. Post-discharge, many patients receive diligent and frequent follow-up. However, rehospitalization rates remain high. One potential explanation is a persistent failure by clinicians to adequately manage congestion in the outpatient setting. The failure to successfully manage these patients post-discharge may represent an unmet need to improve the way congestion is both recognized and treated. A primary aim of future HF management may be to improve clinical surveillance to prevent and manage chronic fluid overload while simultaneously maximizing the use of evidence-based therapies with proven long-term benefit. Improvement in cardiac function is the ultimate goal and maintenance of a "dry" clinical profile is important to prevent hospital admission and improve prognosis. This paper focuses on methods for monitoring congestion, and strategies for water and sodium management in the context of the complex interplay between the cardiac and renal systems. A rationale for improving recognition and treatment of congestion is also proposed. 

Retracted: No

PubPeer comments:
 Parrinello et al cite and discuss findings from two previous papers from their own research group - a 2008 paper by Paterna et al published in Clinical Science and a paper by Parrinnello 2009 in the Journal of Cardiac Failure. Both papers have been found to contain duplicated data. Data from both these studies were contained in a 2012 systematic review published in BMJ Heart journal that had one of the authors here (di Pasquale) as the second author. The systematic review was later retracted (Aug 21, 2012) due to the inability of the study group to provide the original data to verify the duplicate data issues due to a u201ccomputer failureu201d. Furthermore, a 2013 Cochrane review on reduced dietary salt for cardiovascular disease was withdrawn by the Cochrane Heart Group as it had cited the Paterna 2008 paper in a previous version, and states: Following doubts raised about the integrity of research from the Paterna group and retraction of a publication by this group (DiNicolantonio J 2013) we have now removed this trial and its data from this review. The editorial group responsible for this previously published document have withdrawn it from publication. Additional PubPeer posts for these two specific papers are available: https: pubpeer.com publications E03BB72DBAA939C61082F4608D558B https: pubpeer.com publications B24491C479E0C003418D1F1CBECE07 A complete blog of the story leading to retraction of the BMJ Heart systematic review is available here: https: www.cebm.net 2019 02 salt-reduction-in-heart-failure-where-has-the-uncertainty-come-from , 
 I raised the above concerns with the Senior Research Integrity Adviser for the journal publisher, Tim Kersjes in Nov 2019 who informed me he would raise the issue with the EIC of Heart Failure Reviews. Something major happened between early 2020 and April 2021 meaning not much movement, though Tim did update me of progress in May 2020. On May 1 2021, Tim contacted again to inform me of the Editorial Expression of Concern posted by the journal editor(s) for this paper. Here is that expression: https: link.springer.com article 10.1007 s10741-021-10113-w Thanks to Tim and the journal Editor(s) for doing the right thing. ,