Intimate Partner Violence Fear-11 Scale: An Item Response Analysis.

Objective: Victims of intimate partner violence (IPV) often fear their intimate partners and the abuse they perpetrate against them. Fear in the context of IPV has been studied for decades yet, we lack a rigorously validated measure. The purpose of this study was to comprehensively evaluate the psychometric properties of a multi-item scale measuring fear of an abusive male partner and/or the abuse he perpetrates. Method: We used Item Response modeling to evaluate the psychometric properties of a scale measuring women's fear of IPV by their male partner across two distinct samples: 1) a calibration sample of 412 women and 2) a confirmation sample of 298 women. Results: Results provide a detailed overview of the psychometric functioning of the Intimate Partner Violence Fear-11 Scale. Items were strongly related to the latent fear factor, with discrimination values universally above a = 0.80 in both samples. Overall, the IPV Fear-11 Scale is psychometrically robust across both samples. All items were highly discriminating and the full scale was reliable across the range of the latent fear trait. Reliability was exceptionally high for measuring individuals experiencing moderate to high levels of fear. Finally, the IPV Fear-11 Scale was moderately to strongly correlated with depression symptoms, posttraumatic stress symptoms and physical victimization. Conclusions: The IPV Fear-11 Scale was psychometrically robust across both samples and was associated with a number of relevant covariates. Results support the utility of the IPV Fear-11 Scale for assessing fear of an abusive partner among women in relationships with men.

The Role of Acculturation in the Relation Between Intimate Partner Violence and Substance Misuse Among IPV-victimized Hispanic Women in the Community.

Hispanic women in the United States are disproportionately affected by intimate partner violence (IPV). One correlate of IPV among Hispanic women with important public health implications is substance misuse. However, limited research has identified culturally relevant factors that may impact the strength of the IPV-substance misuse association in this population. The present study examined the moderating role of acculturation in the relation between IPV types (i.e., physical, psychological, and sexual) and substance (i.e., alcohol and drug) misuse. Participants were 150 IPV-exposed Hispanic women in the community (M age = 35.13). IPV types, substance misuse outcomes, and acculturation were significantly and positively correlated with each other at zero-order. Moderation analyses indicated that the relations between IPV and substance misuse were stronger among Hispanic women with higher (vs. lower) levels of acculturation. These findings suggest the potential utility of considering acculturation when assessing and treating substance misuse among IPV-exposed Hispanic women.

Alcohol Misuse and Women's Use of Aggression in Intimate Relationships: The Mediating Role of Motivations for Using Aggression.

The relationship between alcohol misuse and women's use of intimate partner violence (IPV) aggression has been well studied; however, there has been no research to date on women's self-reported motivations for use of IPV aggression (e.g., self-defense, control) as an underlying mechanism explaining this link. Accordingly, this study aims to examine whether the effects of alcohol misuse on IPV aggression vary as a function of women's motivations for using aggression. Participants were 412 ethnically diverse community women, between the ages of 18 and 65, in intimate relationships characterized by bidirectional IPV. The Motives and Reasons for IPV Scale was used to assess women's reasons for using IPV aggression. Results revealed that the tough guise motive (i.e., wanting to appear tough, intimidating, and willing to harm one's partner) explained the relationship between alcohol misuse and physical and sexual IPV aggression. Findings suggest the utility of incorporating the assessment of women's motivations for IPV aggression in an effort to provide better informed intervention addressing the underlying reasons women use IPV aggression.

Women's Use of Aggression and Their Depressive Symptoms: The Mediating Effect of Aggression-Related Shame and Avoidance Coping Among Women Experiencing Bidirectional Intimate Partner Violence.

Research is scarce on the consequences of women's use of aggression on their depressive symptoms, particularly in relationships where women use and are victimized by intimate partner violence (IPV). Further, research has yet to identify factors that may mediate the aggression-depressive symptoms link among women who experience bidirectional IPV. The present study examined the potential mediating roles of shame and avoidance coping in the relationship between women's use of intimate partner aggression and their depressive symptoms. Participants were a community sample of 369 women who used and were victimized by physical aggression with a current male partner in the previous 6 months. A serial multiple mediator model was used to examine the mediating roles of aggression-related shame and avoidance coping on the relation between women's use of aggression and depressive symptoms. Results showed a significant indirect effect of women's use of aggression on their depressive symptoms through both aggression-related shame and avoidance coping; indirect effects were not significant through each mediator separately. After controlling for women's IPV victimization, we found a positive association between women's use of aggression and aggression-related shame, which in turn was related to greater avoidance coping, and subsequently, greater depressive symptoms. These findings highlight the importance of examining shame and avoidance coping as consequences of women's use of aggression and its effects on poorer mental health outcomes among women who use and are victimized by IPV.

Racial/ethnic differences moderate associations of coping strategies and posttraumatic stress disorder symptom clusters among women experiencing partner violence: a multigroup path analysis.

BACKGROUND: Past research underscores the key role of coping strategies in the development, maintenance, and exacerbation of posttraumatic stress disorder (PTSD) symptoms. The goal of the current study was to extend existing literature by examining whether race/ethnicity moderates the relations among coping strategies (social support, problem-solving, avoidance) and PTSD symptom clusters (intrusion, avoidance, numbing, arousal). METHODS: Participants were 369 community women (134 African Americans, 131 Latinas, 104 Whites) who reported bidirectional aggression with a current male partner. Multigroup path analysis was utilized to test the moderating role of race/ethnicity in a model linking coping strategies to PTSD symptom clusters. RESULTS: The strength and direction of relations among coping strategies and PTSD symptom clusters varied as a function of race/ethnicity. Greater social support coping was related to more arousal symptoms for Latinas and Whites. Greater problem-solving coping was related to fewer arousal symptoms for Latinas. Greater avoidance coping was related to more symptoms across many of the PTSD clusters for African Americans, Latinas, and Whites, however, these relations were strongest for African Americans. CONCLUSION: Results provide support for the moderating role of race/ethnicity in the relations among coping strategies and PTSD symptom clusters, and highlight potential targets for culturally informed PTSD treatments.

Pharmacokinetics, Pharmacodynamics, and Safety of ASP015K (Peficitinib), a New Janus Kinase Inhibitor, in Healthy Subjects.

Two randomized, double-blind, placebo-controlled studies are reported that had the objective to evaluate the pharmacokinetics, pharmacodynamics, and safety of ASP015K (peficitinib), a Janus kinase (JAK) inhibitor, in healthy subjects. The single-dose study included 7 male groups (3-300 mg) and 2 female groups (30 or 200 mg), n = 8/group (6 on ASP015K and 2 on placebo in each group). The multiple-dose study included 1 female and 3 male groups, n = 12/group (9 on ASP015K and 3 on placebo in each group), who received ASP015K (30 mg) or placebo every 12 hours (twice a day) for 14 days. In the single-dose study, plasma ASP015K concentration increased dose-proportionally. Food increased ASP015K exposure (AUCinf ) by 27%. Mean peak JAK inhibition increased with dose, from 6% at 4 hours (median) following ASP015K 3 mg to 93% (range, 89%-98%) at 2 hours (median) after ASP015K 300 mg. In the multiple-dose study, ASP015K plasma exposure reached steady state by day 3. On day 14, mean ASP015K peak concentration was 38%-65% higher than after the first dose; peak JAK inhibition following 100 or 200 mg twice daily was >85%. The most common adverse events (AEs) were neutropenia, headache, and abdominal pain; no serious AEs occurred. The safety findings at pharmacologically effective doses of ASP015K support further clinical development.

Multi-College Bystander Intervention Evaluation for Violence Prevention.

INTRODUCTION: The 2013 Campus Sexual Violence Elimination Act requires U.S. colleges to provide bystander-based training to reduce sexual violence, but little is known about the efficacy of such programs for preventing violent behavior. This study provides the first multiyear evaluation of a bystander intervention's campus-level impact on reducing interpersonal violence victimization and perpetration behavior on college campuses. METHODS: First-year students attending three similarly sized public university campuses were randomly selected and invited to complete online surveys in the spring terms of 2010-2013. On one campus, the Green Dot bystander intervention was implemented in 2008 (Intervention, n=2,979) and two comparison campuses had no bystander programming at baseline (Comparison, n=4,132). Data analyses conducted in 2014-2015 compared violence rates by condition over the four survey periods. Multivariable logistic regression was used to estimate violence risk on Intervention relative to Comparison campuses, adjusting for demographic factors and time (2010-2013). RESULTS: Interpersonal violence victimization rates (measured in the past academic year) were 17% lower among students attending the Intervention (46.4%) relative to Comparison (55.7%) campuses (adjusted rate ratio=0.83; 95% CI=0.79, 0.88); a similar pattern held for interpersonal violence perpetration (25.5% in Intervention; 32.2% in Comparison; adjusted rate ratio=0.79; 95% CI=0.71, 0.86). Violence rates were lower on Intervention versus Comparison campuses for unwanted sexual victimization, sexual harassment, stalking, and psychological dating violence victimization and perpetration (p<0.01). CONCLUSIONS: Green Dot may be an efficacious intervention to reduce violence at the community level and meet Campus Sexual Violence Elimination Act bystander training requirements.

Intimate partner aggression-related shame and posttraumatic stress disorder symptoms: The moderating role of substance use problems.

A dearth of literature has examined the consequences of women's use of aggression in intimate relationships. Women's use of aggression against their intimate partners, regardless of their motivation (e.g., self-defense, retaliation), may elicit shame. Shame, in turn, may contribute to the maintenance and/or exacerbation of posttraumatic stress disorder (PTSD) symptoms, which are commonly experienced in this population. Further, emerging research suggests that emotionally avoidant coping strategies, such as substance use, may strengthen the relation between shame and PTSD symptoms. The goal of the present study was to examine whether women's shame concerning their use of intimate partner aggression is associated with their PTSD symptoms, and whether drug and alcohol use problems moderate this association. Participants were 369 community women who had used and been victimized by physical aggression in an intimate relationship with a male partner in the past six months. The intimate partner aggression-related shame × drug (but not alcohol) use problems interaction on PTSD symptom severity was significant. Analysis of simple slopes revealed that women's intimate partner aggression-related shame was positively associated with their PTSD symptoms when drug use problems were high, but not when drug use problems were low. Findings have implications for the potential utility of PTSD treatments targeting a reduction in shame and maladaptive shame regulation strategies (i.e., drug use) in this population. Aggr. Behav. 42:427-440, 2016. © 2015 Wiley Periodicals, Inc.

A dangerous boomerang: Injunctive norms, hostile sexist attitudes, and male-to-female sexual aggression.

This study examined the interactive effects of injunctive norm exposure and hostile and benevolent sexist attitudes on men's sexually aggressive responses during a behavioral analogue paradigm in which they interacted online with a bogus female partner. Heterosexual adult men (n = 201), recruited from an online sample, read fictional information regarding other men's approval of misogynistic, paternalistic, or egalitarian treatment of women, or non-gender-relevant control information. Through a media preference survey, men then learned that their female partner disliked sexual content in films, after which they had an opportunity to send her up to 120 sec' worth of either a sexually explicit or nonsexual film clip. Validating the online sexual aggression paradigm, men with a 1-year history of sexual assault exhibited more sexually aggressive responding during the film selection paradigm. Moreover, exposure to injunctive norm information produced a boomerang effect, such that men high in hostile sexist attitudes showed an increase in sexual aggression when confronted with paternalism and gender equality norms. Conversely, exposure to paternalism and gender equality norms suppressed the otherwise protective function of high benevolent sexism in reducing men's sexually aggressive tendencies. The implications of these results for social norms interventions are discussed.

Evaluation of the Green Dot Bystander Intervention to Reduce Interpersonal Violence Among College Students Across Three Campuses.

Evidence suggests that interventions to engage bystanders in violence prevention increase bystander intentions and efficacy to intervene, yet the impact of such programs on violence remains unknown. This study compared rates of violence by type among undergraduate students attending a college campus with the Green Dot bystander intervention (n = 2,768) with students at two colleges without bystander programs (n = 4,258). Violent victimization rates were significantly (p < .01) lower among students attending the campus with Green Dot relative to the two comparison campuses. Violence perpetration rates were lower among males attending the intervention campus. Implications of these results for research and practice are discussed.

A Comparison of the Structural Factors of the Propensity for Abusiveness Scale for Women and Men in a Domestic Violence Treatment Program.

Court-mandated domestic violence (DV) treatment programs across the country have seen a marked increase in female clients. These programs use a variety of measurement tools to assess the needs of their clients. Increased numbers of women in treatment for DV reflect a need to address the measurement of intimate partner violence (IPV) for both males and females. Unfortunately, the reliability and validity of many of measures used to assess IPV and related constructs for women remains unknown. The current study focuses on a particular measure, the Propensity for Abusiveness Scale (PAS). The PAS is not a measure of abusive behavior per se; rather, it assesses risk factors for abuse, including affective lability, anger expression, trauma symptoms, and harsh parenting experienced by the respondent. Specifically, the current study compares the factor structure and the measurement properties of the PAS for males and females in a sample of 885 (647 female, 238 male) participants in a DV treatment program. Findings indicate that the PAS demonstrated configural, metric, and scalar invariance between the female and male samples. These results suggest that it is appropriate for researchers and clinicians to make comparisons between women and men based on PAS factor scores.

The mediating role of avoidance coping between intimate partner violence (IPV) victimization, mental health, and substance abuse among women experiencing bidirectional IPV.

Avoidance coping is consistently linked with negative mental health outcomes among women experiencing intimate partner violence (IPV). This study extended the literature examining the potentially mediating role of avoidance coping strategies on both mental health and substance use problems to a highly generalizable, yet previously unexamined population (i.e., women experiencing bidirectional IPV) and examined multiple forms of IPV (i.e., psychological, physical, and sexual) simultaneously. Among a sample of 362 women experiencing bidirectional IPV, four separate path models were examined, one for each outcome variable. Avoidance coping mediated the relationships between psychological and sexual IPV victimization and the outcomes of PTSD symptom severity, depression severity, and drug use problems. Findings indicate nuanced associations among IPV victimization, avoidance coping, and mental health and substance use outcomes.

Elucidating posttraumatic stress symptom profiles and their correlates among women experiencing bidirectional intimate partner violence.

OBJECTIVE: This study employed latent class analysis to identify profiles of women experiencing intimate partner violence (IPV) based on the severity of posttraumatic stress disorder (PTSD) symptoms. METHOD: Self-report data from a sample of 369 women experiencing bidirectional IPV was used. RESULTS: A 3-class solution comprising low, moderate, and high PTSD severity profiles best fit the data. Profiles were differentially related to whether IPV victimization was considered traumatic (PTSD criterion A); whether functioning was impaired as a result of PTSD symptoms (PTSD criterion F); whether the woman met full diagnostic criteria for PTSD; depression symptom severity; and severity of psychological, physical, and sexual IPV victimization and use of IPV. An extremely high percentage of women in the high (96%) and moderate (88%) severity classes experienced functional impairment, although many did not meet full diagnostic criteria for PTSD. CONCLUSIONS: Findings support the need for interventions individually tailored to one's treatment needs based on the nature of one's traumatic stressor and the impact of PTSD on daily functioning.

Relationship self-efficacy protects against mental health problems among women in bidirectionally aggressive intimate relationships with men.

Research examining predictors or correlates of mental health problems among women who experience or use aggression in intimate relationships typically assesses factors that confer risk. Such research has primarily examined intimate partner violence (IPV) victimization or aggression frequency or severity as central risk factors for mental health problems. In the general population, one factor demonstrating a protective effect on mental health problems is self-efficacy. Research on self-efficacy among women who experience or use aggression in intimate relationships is nearly absent. The purpose of this study was to determine if self-efficacy specific to a woman's ability to manage various relationship problems (i.e., relationship self-efficacy [RSE]) played a protective role against the severity of posttraumatic stress, depression, and anxiety symptoms among 354 community-residing women who were victimized and used aggression (bidirectional IPV). Regression analyses found that RSE uniquely predicted each mental health outcome above and beyond what was accounted for by the frequency of physical, sexual, and psychological victimization and aggression. Further, RSE fully mediated the relationships between psychological victimization and each mental health outcome. If replicated, and in circumstances where it is determined safe to do so, findings suggest RSE as a promising avenue for future research to improve the health and well-being of women in bidirectionally aggressive relationships.

Exploring rape myths, gendered norms, group processing, and the social context of rape among college women: a qualitative analysis.

The purpose of this research is to explore the negotiation strategies of college women as they interpret ambiguous rape scenarios. In focus groups, 1st- and 4th-year college women were presented with a series of three vignettes depicting incidents that meet the legal criteria for rape yet are ambiguous due to the presence of cultural rape myths, contexts involving alcohol consumption, varying degrees of consent, and a known perpetrator. These contexts are critical in understanding how college women define rape. Key findings indicated many of these college women utilized rape myths and norms within their peer groups to interpret rape scenarios.

Patterns of resource utilization and mental health symptoms among women exposed to multiple types of victimization: a latent class analysis.

Although the value of resources aimed to support women who experience intimate partner violence (IPV) is clear, few studies have investigated how exposure to multiple types of victimization influences women's resource utilization. We applied latent class analysis (LCA) to a sample of 412 women who used IPV in their current relationships to test whether women's resource utilization is associated with different patterns of victimization, including current IPV victimization, past IPV victimization, and childhood victimization. Three classes of women were identified: the Low Cumulative IPV class (n = 121) included women with a low prevalence of past IPV victimization and low severity of current IPV victimization; The High Past/ Low Current IPV class (n = 258) included women with a high prevalence of past IPV victimization but low severity of current IPV victimization; and the High Cumulative IPV class (n = 33) included women with a high prevalence of past IPV victimization and severe current IPV victimization. Multiple types of childhood victimization were highly prevalent among women in all three classes. Women in the High Cumulative IPV class used a greater variety of resources, experienced a greater number of posttraumatic stress and depression symptoms, drug problems, and used more severe IPV aggression compared to women in other classes. These findings highlight the heterogeneity of resource utilization among women in relationships characterized by bidirectional IPV and underscore the potential clinical utility of adapting services to meet the specific needs of women with unique profiles of victimization.

Pharmacokinetic and pharmacodynamic profile of rosuvastatin in patients with end-stage renal disease on chronic haemodialysis.

BACKGROUND: Rosuvastatin has been shown to provide effective treatment of dyslipidaemia in patients with end-stage renal disease (ESRD) undergoing haemodialysis, but data from controlled trials are very limited on the pharmacokinetics and pharmacodynamics of rosuvastatin in this population. OBJECTIVE: The aim of the present study was to better define the pharmacokinetic and pharmacodynamic profiles of repeated doses of rosuvastatin at a starting dose of 10 mg/day in a group of patients with ESRD. STUDY DESIGN: This was a single-centre, open-label study of rosuvastatin 10 mg daily, given over a 16-day treatment period in patients with ESRD undergoing chronic haemodialysis. SETTING: The study was carried out at a single site in the USA. PATIENTS: Patients aged 18-65 years with ESRD who had been on dialysis for ≥ 3 months were eligible for inclusion. Of 12 patients enrolled, 11 were included in the pharmacokinetic and pharmacodynamic analysis and all were included in the safety evaluation. The mean age of patients was 43.9 years (range 24-60 years). Five patients were Caucasian, six were black and one was Hispanic. INTERVENTION: Patients received an oral dose of rosuvastatin 10 mg once daily in the morning for 16 consecutive days. MAIN OUTCOME MEASURE: The primary objective was to estimate the degree of rosuvastatin accumulation in plasma by measuring the area under the plasma concentration time curve (AUC) from time zero to 24 h following a single dose of rosuvastatin 10 mg on day 1, and the AUC at steady state on day 15. RESULTS: Following administration of single and multiple doses, plasma concentrations of rosuvastatin declined in an apparent bi-exponential manner and remained above the limit of assay detection throughout the entire sampling periods on both day 1 and day 15. Steady-state plasma concentrations of rosuvastatin were achieved by day 11. Little accumulation of rosuvastatin after repeated, once-daily dosing was observed; the geometric mean accumulation ratio for rosuvastatin was 1.37 (coefficient of variation = 36.4 %). Clearance of rosuvastatin and its metabolites via dialysis was minimal. Following rosuvastatin 10 mg daily for 16 days, total cholesterol, low-density lipoprotein cholesterol and apolipoprotein B were reduced from baseline by 30.6 %, 38.9 % and 30.6 %, respectively. Rosuvastatin was well tolerated. CONCLUSION: The degree of rosuvastatin accumulation observed in patients receiving dialysis is similar to that in healthy individuals. The results of the current study suggest that rosuvastatin 10 mg may be administered to patients with ESRD on chronic haemodialysis without need for dose reduction.

Factor structures for aggression and victimization among women who used aggression against male partners.

Theories and measures of women's aggression in intimate relationships are only beginning to be developed. This study provides a first step in conceptualizing the measurement of women's aggression by examining how well three widely used measures (i.e., the Revised Conflict Tactics Scales (CTS), the Sexual Experiences Survey [SES], and the Psychological Maltreatment of Women Inventory [PMWI]) perform in assessing women's perpetration of and victimization by aggression in their intimate relationships with men. These constructs were examined in a diverse sample of 412 African American, Latina, and White women who had all recently used physical aggression against a male intimate partner. The factor structures and psychometric properties of perpetration and victimization models using these measures were compared. Results indicate that the factor structure of women's perpetration differs from that of women's victimization in theoretically meaningful ways. In the victimization model, all factors performed well in contributing to the measurement of the latent victimization construct. In contrast, the perpetration model performed well in assessing women's physical and psychological aggression but performed poorly in assessing women's sexual aggression, coercive control, and jealous monitoring. Findings suggest that the power and control model of intimate partner violence (IPV) may apply well to women's victimization but not as well to their perpetration of violence.

Effect of hepatic or renal impairment on the pharmacokinetics of casopitant, a NK-1 receptor antagonist.

Two studies were conducted in subjects with mild or moderate hepatic or renal impairment and subjects with normal organ function to evaluate the pharmacokinetics of casopitant and to assess its safety in these populations. A total of 26 subjects were enrolled in the hepatic impairment study and 18 subjects in the renal impairment study. All subjects received oral casopitant 100 mg once-daily for 5 days. Casopitant area under the concentration-time curve (AUC) increased 11% and 24% in subjects with mild or moderate hepatic impairment, respectively, on Day 1, compared with subjects with normal hepatic function; a similar increase was observed on Day 5. The AUC of the active major metabolite, GSK525060, was reduced 29% and 19% on Days 1 and 5, respectively, in subjects with moderate hepatic impairment, but not altered by mild hepatic impairment. Casopitant AUC increased 34% and 22% on Day 1 in subjects with mild or moderate renal impairment, respectively, and 28% and 11% on Day 5, respectively, compared with subjects with normal renal function. GSK525060 AUC was increased 17% and 24% on Days 1 and 5, respectively, in subjects with mild renal impairment; but did not significantly change in subjects with moderate renal impairment. Further age-adjusted analysis showed no meaningful effect of renal impairment on casopitant or GSK525060 AUC. Plasma protein binding of casopitant and GSK525060 was similar in all subjects. The pharmacokinetics of casopitant is not altered to a clinically significant extent in subjects with mild or moderate, hepatic or renal impairment. The impact of severe hepatic or renal impairment was not evaluated.

Renal effects of conivaptan, furosemide, and the combination in patients with chronic heart failure.

BACKGROUND: Loop diuretics, though often effective for treating congestion, have significant limitations. Discovering ways to limit exposure to loop diuretics while achieving effective decongestion is an important goal of current clinical research in heart failure (HF). Vasopressin antagonists are effective in removing large amounts of water, but not salt, in HF. Few data exist about the detailed renal and hormonal effects of these agents compared with or in combination with loop diuretics. This study investigated the renal and neurohormonal effects of loop diuretics, the mixed vasopressin antagonist conivaptan, and the combination in patients with chronic stable HF. METHODS AND RESULTS: In 8 patients with chronic stable HF on standard medical treatment, heart rate, arterial pressure, systemic vascular resistance, and cardiac output (the latter 2 by using impedance cardiography), as well as glomerular filtration rate (iothalamate clearance), renal blood flow (para-aminohippurate clearance), urinary volumes and urinary sodium, plasma catecholamines, renin activity, arginine vasopressin, and B-type natriuretic peptide were assessed before and at hourly intervals for 4 hours after receiving furosemide, conivaptan, or the combination on 3 different study days at a minimum of 1-week intervals. There were no significant effects of conivaptan, furosemide, or the combination on any hemodynamic variable, neurohormonal level, renal blood flow, or glomerular filtration rate. Conivaptan and furosemide similarly increased urine volumes; the effect of the combination was significantly greater. Furosemide, but not conivaptan, increased urinary sodium excretion, and the combination was significantly greater than after furosemide alone. CONCLUSIONS: Without adversely affecting important hemodynamic variables, neurohormones, renal blood flow, or glomerular filtration rate, conivaptan significantly augmented both the diuretic and the natriuretic response to furosemide in patients with chronic HF. These results may have implications for the design of furosemide-sparing regimens in the treatment of acute HF.