Hendren NS, et al. – This study hypothesized an association of factors outside net–fluid loss with symptomatic relief as assessed by global well–being (GVAS) and dyspnea visual assessment scales (DVAS) in patients with acute decompensated heart failure. Despite adjustment for net–fluid loss and other treatment–related factors, changes in GVAS and DVAS were found to be dependent on their baseline levels. Loop diuretic dose (baseline and cumulative), NTproBNP change during treatment, ICD presence, and creatinine change were identified as independent predictors of GVAS; and for DVAS change, only NTproBNP changed during treatment. It appeared that the potential for symptomatic improvement was heavily affected by initial symptom severity.