| The effects of adding torasemide to standard therapy on peak oxygen consumption, natriuretic peptides, and quality of life in patients with compensated left ventricular systolic dysfunction. | |
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MedLine Citation:
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PMID: 20525705 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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AIMS: Diuretics, when used to treat congestion in patients with chronic heart failure, improve symptoms and, perhaps, prognosis but little information is available to guide their use in patients with left ventricular systolic dysfunction (LVSD) who are not congested. Chronic diuretic therapy causes persistent and potentially harmful neuroendocrine activation. Alternatively, in patients in whom neuroendocrine activation is blocked with angiotensin-converting enzyme (ACE)-inhibitors and beta-blockers, diuretics may be beneficial by decreasing preload and afterload and preventing congestion. We aimed to assess the effect of the loop diuretic, torasemide on quality of life, and surrogate markers of prognosis when given to patients with LVSD who were not clinically congested and who were optimally treated with ACE-inhibitors (or angiotensin receptor antagonists) and beta-blockers. METHODS AND RESULTS: Thirty patients with stable LVSD who had no clinically detectable fluid overload were randomized to receive either torasemide 5 mg daily or placebo for 3 months (Phase A), and after a washout phase of 2 months, cross-over was performed for 3 months (Phase B). Diuretic therapy did not cause significant change in peak VO(2), mean N-terminal pro-hormone brain natriuretic peptide (NT-proBNP) levels, or measures of quality of life compared with placebo. Diuretic therapy did however lead to significant fall in systolic and diastolic blood pressures and increase in plasma renin levels compared with placebo. CONCLUSION: Diuretic therapy with torasemide is not superior to placebo in improving peak VO(2) or reducing NT-proBNP levels in patients with left ventricular dysfunction who are not clinically congested. |
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Authors:
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Sanjay Gupta; Carolyn Waywell; Nandkumar Gandhi; Nigel Clayton; Brian Keevil; Andrew L Clark; Leong L Ng; Nicholas Brooks; Ludwig Neyses |
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Publication Detail:
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Type: Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't Date: 2010-06-04 |
Journal Detail:
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Title: European journal of heart failure Volume: 12 ISSN: 1879-0844 ISO Abbreviation: Eur. J. Heart Fail. Publication Date: 2010 Jul |
Date Detail:
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Created Date: 2010-06-25 Completed Date: 2010-10-01 Revised Date: 2011-06-08 |
Medline Journal Info:
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Nlm Unique ID: 100887595 Medline TA: Eur J Heart Fail Country: Netherlands |
Other Details:
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Languages: eng Pagination: 746-52 Citation Subset: IM |
Affiliation:
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Department of Cardiology, Wythenshawe Hospital, Manchester, UK. sanjay.gupta.uk@googlemail.com |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Blood Pressure / drug effects Cross-Over Studies Diuretics / administration & dosage, therapeutic use* Double-Blind Method Drug Therapy, Combination Exercise Test Female Heart Failure / drug therapy*, physiopathology Heart Rate / drug effects Humans Intention to Treat Analysis Middle Aged Natriuretic Peptide, Brain / blood* Oxygen Consumption / drug effects* Peptide Fragments / blood* Prognosis Quality of Life Renin / blood Retrospective Studies Sulfonamides / administration & dosage, therapeutic use* Systole / physiology Ventricular Dysfunction, Left / drug therapy*, physiopathology |
| Chemical | |
Reg. No./Substance:
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0/Diuretics; 0/Peptide Fragments; 0/Sulfonamides; 0/pro-brain natriuretic peptide (1-76); 114471-18-0/Natriuretic Peptide, Brain; 56211-40-6/torsemide; EC 3.4.23.15/Renin |
| Comments/Corrections | |
Comment In:
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Eur J Heart Fail. 2010 Jul;12(7):649-52
[PMID:
20576834
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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