With keen interest, we have read the DIUR-AHF study published by Palazzuoli et al. [1], which provides important real-world evidence on loop diuretic strategies in acute heart failure (AHF). The finding that continuous infusion (CIV) achieved better decongestion but worse 180-day outcomes than bolus therapy (BIV) challenges conventional wisdom and warrants careful interpretation. While we applaud the multicenter design and rigorous endpoint adjudication, three key aspects merit further discussion to guide clinical translation.
