title: Comparative effects of long-acting and short-acting loop diuretics on cardiac sympathetic nerve activity in patients with chronic heart failure.
abstract: Short-acting loop diuretics are known to enhance cardiac sympathetic nerve activity (CSNA) in patients with chronic heart failure (CHF). The effects of two loop diuretics-long-acting azosemide and short-acting furosemide-on CSNA were evaluated using (123)I-metaiodobenzylguanidine (MIBG) scintigraphy in patients with CHF.
  
  
  
  The present study was a subanalysis of our previously published study, which had reported that serial (123)I-MIBG studies were the most useful prognostic indicator in patients with CHF. Patients with CHF (n=208, left ventricular ejection fraction <45%) but no history of cardiac events for at least 5 months prior to the study were identified according to their histories of acute decompensated heart failure requiring hospitalisation. Patients underwent (123)I-MIBG scintigraphy immediately before hospital discharge and at a 6-month follow-up. The delayed % denervation, delayed heart/mediastinum count (H/M) ratio and washout rate (WR) were determined using (123)I-MIBG scintigraphy. A total of 108 patients were selected, and propensity score matching was used to compare patients treated with either oral azosemide (n=54) or furosemide (n=54).
  
  
  
  After treatment, (123)I-MIBG scintigraphic parameters improved in both groups. However, the degree of change in % denervation was -13.8±10.5 in the azosemide group and -5.7±12.7 in the furosemide group (p<0.01), the change in H/M ratio was 0.20±0.16 in the azosemide group and 0.06±0.19 in the furosemide group (p<0.01), and the change in WR was -11.3±9.2% in the azosemide group and -3.0±12.7% in the furosemide group (p<0.01). Moreover, multivariate analysis showed an independent and significant positive relationship between furosemide and δ-WR from hospital discharge to 6 months after treatment in patients with CHF (p=0.001).
  
  
  
  These findings indicate that azosemide suppresses CSNA compared with furosemide in patients with CHF.
  
  
  
  UMIN000000626 (UMIN-CTR Clinical Trial).
authors: Department of Medicine and Biological Science (Cardiovascular Medicine) , Gunma University Graduate School of Medicine , Maebashi , Japan.
authors: Yae
authors: Y
authors: Matsuo
authors: Department of Medicine and Biological Science (Cardiovascular Medicine), Gunma University Graduate School of Medicine, Maebashi, Japan; Department of Cardiology, Cardiovascular Hospital of Central Japan (Kitakanto Cardiovascular Hospital), Gunma, Japan.
authors: Shu
authors: S
authors: Kasama
authors: Department of Medicine and Biological Science (Cardiovascular Medicine) , Gunma University Graduate School of Medicine , Maebashi , Japan.
authors: Takuji
authors: T
authors: Toyama
authors: Department of Medicine and Biological Science (Cardiovascular Medicine) , Gunma University Graduate School of Medicine , Maebashi , Japan.
authors: Ryuichi
authors: R
authors: Funada
authors: Department of Medicine and Biological Science (Cardiovascular Medicine) , Gunma University Graduate School of Medicine , Maebashi , Japan.
authors: Noriaki
authors: N
authors: Takama
authors: Department of Medicine and Biological Science (Cardiovascular Medicine) , Gunma University Graduate School of Medicine , Maebashi , Japan.
authors: Norimichi
authors: N
authors: Koitabashi
authors: Department of Cardiology , Cardiovascular Hospital of Central Japan (Kitakanto Cardiovascular Hospital) , Gunma , Japan.
authors: Shuichi
authors: S
authors: Ichikawa
authors: Department of Cardiology , Nihon University Hospital , Tokyo , Japan.
authors: Yasuyuki
authors: Y
authors: Suzuki
authors: Department of Cardiology , Nihon University Hospital , Tokyo , Japan.
authors: Naoya
authors: N
authors: Matsumoto
authors: Department of Imaging , Health Park Clinic , Takasaki, Gunma , Japan.
authors: Yuichi
authors: Y
authors: Sato
authors: Department of Medicine and Biological Science (Cardiovascular Medicine) , Gunma University Graduate School of Medicine , Maebashi , Japan.
authors: Masahiko
authors: M
authors: Kurabayashi
keywords: AUTONOMIC NERVOUS SYSTEM