2016


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2016/№1

Effects of loop diuretics in basis therapy for chronic heart failure

Mukhamedova M. G.1, Arnopolskaya D. I.2
1 – Tashkent Institute for Physicians’ Continuing Edication”, Parkentskaya 51, Tashkent 100007
2 – Limited Liability Company “Nurshah”, residential area Yunusabad-19, Dekhkonobod 5, Tashkent 100114, Republic of Uzbekistan

Keywords: CHF, brain natriuretic peptide (BNP), pulmonary hypertension, diastolic function, diuretics, torasemide, furosemid

DOI: 10.18087/rhfj.2016.1.2194

Background. Dehydration therapy is a major component in successful treatment of patients with CHF. Aim. To compare effects of loop diuretics, furosemide and torasemide on central hemodynamics, systolic and diastolic heart function, concentrations of brain natriuretic peptide (BNP), exercise tolerance, quality of life, and blood concentrations of electrolytes in CHF of ischemic origin. Materials and methods. The study included 303 (204 males and 99 females) patients with CHF of ischemic origin. Mean age of patients was 62.22±0.87. Control group (CG) consisted of 20 healthy volunteers with comparable anthropometric characteristics without signs of cardiovascular disease. Patients received a basis therapy for CHF (β-AB and ACE inhibitors/ type 1 AII receptor antagonist, aspirin, and statins) for at least 3 months before the time of enrollment. 78 (26 %) patients had FC III CHF and 225 (74 %) patients had FC II CHF. The basis therapy was supplemented with torasemide or furosemide. Results. Addition of torasemide to the standard therapy reduced BNP level by 24.34 % and furosemide by 13.79 % after 3 months of treatment. Compared to furosemide, torasemide exerted a smaller effect on potassium concentration (–2.25 % vs. –5.73 %; p<0.05) and a comparable effect on magnesium concentration (–5.25 % and–5.47 %, respectively). Loop diuretics exerted a beneficial effect on time-related changes in all EchoCG parameters. Torasemide exerted a greater effect than furosemide on the left ventricular diameter (–4.36 % vs. –2.24 %; p<0.001) and LV EF (+6.63 % vs. +2.86 %; p<0.01). The 3-month loop diuretic treatment, the torasemide treatment to a greater degree, provided a decrease in mean pulmonary artery pressure (–9.26 % vs. –5.67 %; p<0.001). Torasemide provided significant improvement of originally impaired quality of life (32.16 % vs. 18.05 % for furosemide treatment; p<0.001).
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Mukhamedova M. G., Arnopolskaya D. I. Effects of loop diuretics in basis therapy for chronic heart failure. Russian Heart Failure Journal. 2016;17 (1):34–40

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