Effect of Diuretics Withdrawal in Chronic Heart Failure With Reduced Ejection Fraction

INCLUSION CRITERIA: * Outpatients diagnosed of chronic HFrEF by criteria of ESC Guidelines of 2021 * Age equal or greater than 18 year-old * Stable and euvolemic outpatients determined by clinical criteria, biomarkers (CA-125 \< 23 U/mL) and bioelectrical impedance analysis * Left Ventricular Ejection Fraction less than 50% by echocardiography or cardiovascular magnetic resonance performed within 6 months before the screening visit * New York Heart Association functional class I or II * No episodes of acute decompensated heart failure within 2 months before the screening visit * Treatment with a stable dose of diuretic for at least 1 month before the screening visit * Optimal medical therapy with ACEI/ARNI, BB, MRA and iSGLT2 must be started to titration unless any of them were contraindicated or not tolerated * Plasma potassium \< 5 mg/dl in the screening visit EXCLUSION CRITERIA: * Acute coronary syndrome within 3 months before screening visit * Awaiting cardiac resynchronization therapy * Any severe valve heart disease not yet treated * Pulmonary hypertension or any severe pulmonary disease * End-stage chronic kidney disease (on hemodialysis). Acute kidney injury * Severe hepatic failure or cirrhosis * Malignancy on active treatment * Congenital heart disease * Awaiting cardiac transplantation * Inability to understand and sign the informed consent * Participation in any other interventional clinical research