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Effect of loop diuretics on the clinical course and LV filling pressure in patients with compensated heart failure, with preserved ejection fraction and high LV filling pressure

Ovchinnikov A. G., Azizova A. G., Masenko V. P., Shatalina L. S., 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, left ventricle, loop diuretic, heart failure, EF

DOI: 10.18087/rhfj.2012.6.1727

Relevance. Despite severity of HF with preserved EF (HFPEF), there are no effective methods of its treatment. Objective. Estimate influence of loop diuretics torasemide and furosemide on the clinical course, filling pressure of LV (LVEF) and biochemical markers of collagen levels in patients with compensated HFСEF and high LVEF. Materials and methods. 39 patients with HFPEF and high LVFP (according to EchoCG), but with no clinical signs of fluid retention, were randomized in torasemide (n=18) and furosemide (n=21) groups. The initial dose of torasemide was 5 mg, furosemide – 10 mg / day. In 2 and 4 weeks, subject to absence of adequate clinical hemodynamic effect (no transition to NYHA I and / or to LV filling type with slowed-down relaxation) the doses were increased (torasemide to 10 and 20 mg, respectively; furosemide – to 20 and 40 mg, respectively). Duration of the study was 6 months. Results. Administration of both products was accompanied by decrease of the average NYHA functional class, decrease of points in the Minnesota questionnaire, as well as drop in LVFP, more expressed in torasemide group (р<0.05 difference between products). Significant decrease in concentration ratio of biochemical markers of PIP / CITP collagen synthesis and disintegration was noted only in torasemide group. Conclusion. Loop diuretics torasemide and furosemide improve functional status and reduce LVFP in patients with compensated HFPEF and high LVFP. In torasemide group, clinical hemodynamic effect is more expressed which is most likely connected with the product’s antifibrotic effect.
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Ovchinnikov A. G., Azizova A. G., Masenko V. P. et al. Effect of loop diuretics on the clinical course and LV filling pressure in patients with compensated heart failure, with preserved ejection fraction and high LV filling pressure. Russian Heart Failure Journal. 2012;13(6):320-333

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