Effects of torasemide on left ventricular function and neurohumoral factors in patients with chronic heart failure.
The effect of torasemide and furosemide therapy was compared in 50 patients who had chronic heart failure and symptoms [NYHA class II-III] despite long-term therapy with both low-dose furosemide and angiotensin-converting enzyme inhibitors. In this randomized 6-month, open-label trial, baseline and follow-up echocardiograms and neurohumoral assays were obtained in 25 group F patients (continued same dose of oral furosemide at 20-40 mg/day) and in 25 group T patients (received torasemide at 4-8 mg/day in place of furosemide). At 6 months, parameters were unchanged in group F whereas the group T patients had a lower left ventricular end-diastolic diameter (p<0.005) and left ventricular mass index (p<0.005) with improved Doppler filling parameters, decreased plasma B-type natriuretic concentration (p<0.001) and increased plasma concentrations of active renin (p<0.005) and aldosterone (p<0.001). The magnitude of these changes appeared dose dependent and it is suggested these favorable effects of switching from furosemide to torasemide may be related to aldosterone receptor blockade.
Division of Cardiology, Osaka Kosei-nenkin Hospital, Osaka, Japan.
Masaki
M
Yamato
Tatsuya
T
Sasaki
Kaduo
K
Honda
Masayuki
M
Fukuda
Osamu
O
Akutagawa
Masakuni
M
Okamoto
Takaharu
T
Hayashi
D000368:Aged; D000450:Aldosterone / Q000097:blood; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000494:pharmacology*; D015150:Echocardiography, Doppler / Q000187:drug effects; D005260:Female; D005500:Follow-Up Studies; D005665:Furosemide / Q000627:therapeutic use; D006333:Heart Failure / Q000188:drug therapy*; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018377:Neurotransmitter Agents / Q000502:physiology*; D012044:Regression Analysis; D013449:Sulfonamides / Q000494:pharmacology*; D000077786:Torsemide; D018487:Ventricular Dysfunction, Left / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology*
D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D018377:Neurotransmitter Agents; D013449:Sulfonamides; D000450:Aldosterone; D005665:Furosemide; D000077786:Torsemide