Russian Heart Failure Journal 2011year Comparative study of Torasemide vs. Furosemide effects on clinical status and diastolic function of the left ventricle in patients with compensated heart failure and high ventricular filling pressure

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Comparative study of Torasemide vs. Furosemide effects on clinical status and diastolic function of the left ventricle in patients with compensated heart failure and high ventricular filling pressure

Azizova A. G., Ovchinnikov A. G., Ageev F. T.
Federal State Budgetary Institution, “Russian Cardiology Research and Production Complex” of the RF Ministry of Health Care, 3rd Cherepkovskaya 15a, Moscow 121552

Keywords: left ventricle filling pressure, diastolic dysfunction of left ventricle,  loop diuretic, heart failure

DOI: 10.18087/rhfj.2011.6.1604

Relevance. Diuretics play the leading part in elimination of venostasis symptoms. However, until now there have been no large-scale studies carried out to estimate efficacy of long-term administration of diuretics in patients with compensated CHF, which does not allow to judge effects of these drugs on the disease prognosis. Purpose. The assessment of effects of the loop diuretics (Torasemide and Furosemide) on the clinical progression and diastolic function of LV in patients with compensated HF and high LV feeling pressure. Materials and methods. 63 patients with II–III class HF, high LV feeling pressure (EchoCG), yet without clinical signs of fluid retention, were randomized to Torasemide (n=33) and Furosemide (n=31) groups. Initial dose of Torasemide was 5 mg, Furosemide – 10 mg a day. In 2 weeks, and, if necessary, in 4 weeks, in the absence of due clinical haemodynamic effect (absence of transition to class I and / or to LV feeling type with the slowed down relaxation) doses of the diuretics were raised (Torasemide to 10 and 20 mg, Furosemide to 20 and 40 mg, respectively). The duration of the study was 6 months. Results. By the end of the study both groups demonstrated comparable significant lowering of average HF functional class, which was more expressed in Torasemide group (р<0.1) in comparison with the change of this parameter in the Furosemide group). Only administration of Torasemide was accompanied with significant increase of 6‑minute walk distance. By the end of dose-finding period, in both groups Doppler results of the indices closely connected with pressure of LV filling improved (significant decrease of E / A, Е / é and E / Vp ratios). However, further administration of Furosemide was accompanied by partial return of these parameters to the initial value, while Torasemide administration continued to have a positive effect on these indices (р <0.1 differences between the drugs of the effect on Е / A ratio and р<0.05 differences of the effect on Е / é and E / Vp ratios). Thus, in patients with compensated HF and high LV filling pressure both Torasemide and Furosemide improve the functional status and reduce LV filling pressure, and Torasemide has more expressed clinical haemodynamic effect, which is, probably, connected with the fact that it has additional mechanisms of influence on heart function.
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Azizova A.G., Ovchinnikov A.G., Ageev F.T. Comparative study of Torasemide vs. Furosemide effects on clinical status and diastolic function of the left ventricle in patients with compensated heart failure and high ventricular filling pressure. Russian Heart Failure Journal2011;12(6):326-332.

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