Document Detail


Effects of torasemide on cardiac sympathetic nerve activity and left ventricular remodelling in patients with congestive heart failure.
MedLine Citation:
PMID:  16621879     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To determine the effect of torasemide, a loop diuretic with antialdosteronergic properties, compared with furosemide on cardiac sympathetic nerve activity in patients with congestive heart failure (CHF).
METHODS: 40 patients with non-ischaemic CHF (left ventricular ejection fraction (LVEF) < 45%) were randomly assigned to torasemide (4-8 mg/day; n = 20) or furosemide (20-40 mg/day; n = 20). All patients were also treated with angiotensin-converting enzyme inhibitor. The delayed heart to mediastinum count (H/M) ratio, delayed total defect score (TDS) and washout rate were determined from iodine-123 meta-iodobenzylguanidine measured before and 6 months after treatment. Left ventricular end diastolic volume (LVEDV), left ventricular end systolic volume (LVESV) and LVEF were also determined by echocardiography.
RESULTS: After treatment, in patients receiving torasemide, TDS decreased from 44 (8) to 36 (8) (p < 0.001), H/M ratio increased from 1.61 (0.19) to 1.77 (0.24) (p < 0.001), and washout rate decreased from 52 (12)% to 41 (14)% (p = 0.001). In addition, LVEDV decreased from 173 (22) ml to 147 (30) ml (p < 0.001) and LVESV decreased from 117 (19) ml to 95(24) ml (p < 0.001). Although LVEF tended to increase, the change was not significant (from 31 (7)% to 34 (7)%, NS). Conversely, these parameters did not change significantly in patients receiving furosemide. Moreover, percentage change of TDS was significantly correlated with percentage change of LVEDV (r = 0.473, p < 0.05) and of LVESV (r = 0.579, p < 0.01) after torasemide treatment.
CONCLUSION: These findings indicate that torasemide treatment can ameliorate cardiac sympathetic nerve activity and left ventricular remodelling in patients with CHF.
Authors:
S Kasama; T Toyama; T Hatori; H Sumino; H Kumakura; Y Takayama; S Ichikawa; T Suzuki; M Kurabayashi
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial     Date:  2006-04-18
Journal Detail:
Title:  Heart (British Cardiac Society)     Volume:  92     ISSN:  1468-201X     ISO Abbreviation:  Heart     Publication Date:  2006 Oct 
Date Detail:
Created Date:  2006-09-15     Completed Date:  2006-10-20     Revised Date:  2013-06-07    
Medline Journal Info:
Nlm Unique ID:  9602087     Medline TA:  Heart     Country:  England    
Other Details:
Languages:  eng     Pagination:  1434-40     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiovascular Medicine, Gunma University School of Medicine, 3-39-15, Showa-machi, Maebashi, Gunma 371-0034, Japan.
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MeSH Terms
Descriptor/Qualifier:
Aged
Autonomic Nervous System Diseases / drug therapy*,  physiopathology,  radionuclide imaging
Diuretics / therapeutic use*
Female
Furosemide / therapeutic use
Heart Failure / drug therapy*,  physiopathology,  radionuclide imaging
Humans
Male
Middle Aged
Natriuretic Peptide, Brain / blood
Observer Variation
Stroke Volume / physiology
Sulfonamides / therapeutic use*
Tomography, Emission-Computed, Single-Photon
Ventricular Remodeling / physiology*
Chemical
Reg. No./Substance:
0/Diuretics; 0/Sulfonamides; 114471-18-0/Natriuretic Peptide, Brain; 54-31-9/Furosemide; 56211-40-6/torsemide
Comments/Corrections

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