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Loop diuretic, heart failure

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https://www.readbyqxmd.com/read/28321027/effects-of-long-acting-loop-diuretics-in-heart-failure-with-reduced-ejection-fraction-patients-with-cardiac-resynchronization-therapy
#1
Masahiko Asami, Jiro Aoki, Shuzou Tanimoto, Yu Horiuchi, Mika Watanabe, Koichi Furui, Kentaro Yasuhara, Tatsuyuki Sato, Kengo Tanabe, Kazuhiro Hara
There have been no reports evaluating the impact of long-acting loop diuretics (LLD) on the outcome of heart failure (HF) and arrhythmia treatment in HF with reduced ejection fraction (HFrEF) patients implanted with a cardiac resynchronization therapy (CRT) device.This was a prospective, single-blind, randomized crossover study. We allocated 21 consecutive CRT implanted patients into 2 groups. The furosemide group received furosemide as a first treatment and azosemide as a second treatment. The azosemide group received this treatment in the reverse order...
March 17, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28302060/heart-failure-labelled-patients-with-missing-ejection-fraction-in-primary-care-prognosis-and-determinants
#2
Miguel-Angel Muñoz, Xavier Mundet-Tuduri, Jordi Real, José-Luis Del Val, Mar Domingo, Ernest Vinyoles, Ester Calero, Caterina Checa, Nuria Soldevila-Bacardit, José-María Verdú-Rotellar
BACKGROUND: It is common to find a high variability in the accuracy of heart failure (HF) diagnosis in electronic primary care medical records (EMR). Our aims were to ascertain (i) whether the prognosis of HF labelled patients whose ejection fraction (EF) was missing in their EMR differed from those that had it registered, and (ii) the causes contributing to the differences in the availability of EF in EMR. METHODS: Retrospective cohort analyses based on clinical records of HF and attended at 52 primary healthcare centres of Barcelona (Spain)...
March 17, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28290870/-selection-of-diuretic-therapy-in-cardiology-practice
#3
T E Morozova, I Y Yudina
Diuretic drugs - one of the most frequently prescribed groups of drugs in cardiology practice, primarily in patients with arterial hypertension (AH) and chronic heart failure (CHF). The article discusses the features of thiazide and loop diuretics, questions the selection of individual representatives of this class of drugs. Particular attention is paid to the loop diuretic torasemide, possessing, in addition to antihypertensive and diuretic effects, additional features such as the ability to reduce the activity of the renin-angiotensin-aldosterone system, reduce the severity of myocardial fibrosis, no negative influence on lipid and carbohydrate exchange, uric acid levels and blood electrolytes...
September 2016: Kardiologiia
https://www.readbyqxmd.com/read/28287293/-classical-antihypertensive-drugs-diuretics
#4
Viktor László Nagy
The diuretics are essential medicaments of antihypertensive therapy. They reduce blood pressure and cardiovascular events optimally. With increasing doses of thiazides and thiazide analogs do not come further powerful effect of reducing blood pressure or cardiovascular mortality and morbidity, but clearly elevate the side effects. Because of it, the minimum effective dose level and the fixed-dose combination therapy should be preferred. The use these drugs leads to especially positive outcome in elder patients, isolated systolic hypertension, heart failure, after stroke and in black population...
March 2017: Orvosi Hetilap
https://www.readbyqxmd.com/read/28279964/serum-creatinine-elevation-after-renin-angiotensin-system-blockade-and-long-term-cardiorenal-risks-cohort-study
#5
Morten Schmidt, Kathryn E Mansfield, Krishnan Bhaskaran, Dorothea Nitsch, Henrik Toft Sørensen, Liam Smeeth, Laurie A Tomlinson
Objective To examine long term cardiorenal outcomes associated with increased concentrations of creatinine after the start of angiotensin converting enzyme inhibitor/angiotensin receptor blocker treatment.Design Population based cohort study using electronic health records from the Clinical Practice Research Datalink and Hospital Episode Statistics.Setting UK primary care, 1997-2014.Participants Patients starting treatment with angiotensin converting enzyme inhibitors or angiotensin receptor blockers (n=122 363)...
March 9, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28243969/diuretic-strategies-in-acute-decompensated-heart-failure
#6
REVIEW
E Ashley Hardin, Justin L Grodin
PURPOSE OF REVIEW: The burden of heart failure in the United States is growing rapidly to epic proportions with serious clinical implications for patients and economic strain for healthcare systems. One of the most common reasons for hospitalization in acute decompensated heart failure (ADHF) is excess volume accumulation which leads to untoward symptoms including dyspnea,orthopnea, and edema. RECENT FINDINGS: Over the past several decades, there has been great interest in exploring various decongestive strategies in order to achieve symptomatic improvement and favorable clinical outcomes...
April 2017: Current Heart Failure Reports
https://www.readbyqxmd.com/read/28198522/cardiovascular-drug-utilization-post-implant-is-related-to-clinical-outcome-in-heart-failure-patients-receiving-cardiac-resynchronization-therapy
#7
Zoltan Bakos, Christian Reitan, Anna Werther-Evaldsson, Anders Roijer, Pyotr PLatonov, Rasmus Borgquist
BACKGROUND: In select patients with heart failure, cardiac resynchronization therapy (CRT) is the most common complementary treatment besides medical treatment. We aimed to assess the association between post CRT-implant changes in cardiovascular medication and cardiovascular mortality and heart failure hospitalization. METHODS: 211 patients on optimal medical therapy eligible for CRT were retrospectively included in this study (72 ± 7 years, 80% male, 66% left bundle branch block [LBBB], 48% dilated cardiomyopathy [DCMP]) and investigated at baseline and after 6 months ...
February 15, 2017: Cardiology Journal
https://www.readbyqxmd.com/read/28177101/-severe-hyperkalemia-in-patients-referred-to-an-emergency-departement-the-role-of-antialdosterone-drugs-and-of-renin-angiotensin-system-blockers
#8
Daria Motta, Giulio Cesano, Angelo Pignataro, Roberto Boero
We analyzed the clinical features and the factors associated with the presence of hyperkalemia (serum potassium >5.3 mmol/L) in a cohort of patients presenting to an Emergency Department. A total of 168 cases were observed (89 males and 79 females), mean age 77.512 years. Fifty-six patients were diabetics (33.3%), 51 patients had chronic kidney disease (30%) and 36 patients with cardiac failure (21.4%). Sixty-nine patients (41%) were treated with RAS-blockers (ACE-I n = 50; ARBs, n = 19). 65 subjects were taking loop diuretics (39%), 17 (10%) thiazides...
January 2017: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/28169056/exploring-the-relation-between-changes-in-nt-probnp-and-renal-function-in-patients-with-suspected-heart-failure-using-structural-equation-modelling
#9
Jufen Zhang, Kenneth Y-K Wong, Andrew L Clark, John G F Cleland
BACKGROUND: The relation between changes in NT-proBNP and renal function has commonly been studied using multiple regressions, which may ignore the complexity of relations between related variables. METHODS AND RESULTS: Data were collected from patients referred with suspected heart failure (HF) to a community service. Structural equation modelling (SEM) was used to assess the association between changes in NT-proBNP at 1year, and other pre-specified variables including age, sex, BMI, eGFR, loop diuretics and ACE inhibitor...
April 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28114980/the-impact-of-torasemide-on-haemodynamic-and-neurohormonal-stress-and-cardiac-remodelling-in-heart-failure-tornado-a-study-protocol-for-a-randomized-controlled-trial
#10
Paweł Balsam, Krzysztof Ozierański, Agata Tymińska, Renata Główczyńska, Michał Peller, Anna Fojt, Andrzej Cacko, Bartosz Sieradzki, Elwira Bakuła, Maciej Markulis, Robert Kowalik, Zenon Huczek, Krzysztof J Filipiak, Grzegorz Opolski, Marcin Grabowski
BACKGROUND: Approximately 50% of heart failure patients are readmitted to hospital within 6 months, owing to deterioration of their condition. Thus, symptomatic treatment of heart failure requires significant improvement. The aim of this study is to compare the effects of torasemide and furosemide on biochemical parameters of haemodynamic and neurohormonal compensation, myocardial remodelling, clinical outcomes and quality of life in patients with chronic heart failure. METHODS: This is a multicentre, randomized, open, blinded endpoint phase-IV trial...
January 23, 2017: Trials
https://www.readbyqxmd.com/read/28105769/renal-tubular-resistance-is-the-primary-driver-for-loop-diuretic-resistance-in-acute-heart-failure
#11
Jozine M Ter Maaten, Veena S Rao, Jennifer S Hanberg, F Perry Wilson, Lavanya Bellumkonda, Mahlet Assefa, J Sam Broughton, Julie D'Ambrosi, W H Wilson Tang, Kevin Damman, Adriaan A Voors, David H Ellison, Jeffrey M Testani
BACKGROUND: Loop diuretic resistance is a common barrier to effective decongestion in acute heart failure (AHF), and is associated with poor outcome. Specific mechanisms underlying diuretic resistance are currently unknown in contemporary AHF patients. We therefore aimed to determine the relative importance of defects in diuretic delivery vs. renal tubular response in determining diuretic response (DR) in AHF. METHODS AND RESULTS: Fifty AHF patients treated with intravenous bumetanide underwent a 6-h timed urine collection for sodium and bumetanide clearance...
January 19, 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/28105515/changes-in-brain-natriuretic-peptide-in-chronic-heart-failure-patients-treated-with-long-acting-versus-short-acting-loop-diuretics-j-melodic-subanalysis
#12
Miho Fukui, Takeshi Tsujino, Shinichi Hirotani, Hiroshi Ito, Kazuhiro Yamamoto, Takashi Akasaka, Yutaka Hirano, Nobuyuki Ohte, Takashi Daimon, Satoshi Nakatani, Masaaki Kawabata, Tohru Masuyama
We have previously reported that a long-acting loop diuretic, azosemide, reduces cardiovascular risks in patients with chronic heart failure (CHF) as compared with a short-acting one, furosemide, in Japanese Multicenter Evaluation of LOng- versus short-acting Diuretics In Congestive heart failure (J-MELODIC). However, the mechanisms of the difference have not been elucidated. This study aimed to examine whether there is a difference in the reduction in plasma brain natriuretic peptide (BNP) level and in left ventricular (LV) functional recovery between the CHF patients treated with the long-acting diuretic (the azosemide group) and the short-acting diuretic (the furosemide group)...
January 19, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/28100428/heart-failure-with-preserved-ejection-fraction-has-a-better-long-term-prognosis-than-heart-failure-with-reduced-ejection-fraction-in-old-patients-in-a-5-year-follow-up-retrospective-study
#13
Silvana Kontogeorgos, Erik Thunström, Magnus C Johansson, Michael Fu
BACKGROUND: The issue of whether prognosis is similar between heart failure with preserved ejection fraction (HFpEF) and heart failure with reduced ejection fraction (HFrEF) remains unresolved. Because of the problem of inconsistency in the diagnostic criteria and because there is currently no lifesaving therapy available for HFpEF, it seems to be the right time to study the outcome of a clearly defined HFpEF compared with HFrEF in contemporary heart failure (HF) therapy. This study investigates 5-year-mortality and its prognostic factors in old patients with HFpEF compared with those with HFrEF...
April 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28008296/point-of-care-ultraportable-echocardiography-predicts-diuretic-response-in-patients-admitted-with-acute-decompensated-heart-failure
#14
Dena K Krishnan, Barbara Pawlaczyk, Peter A McCullough, Susan Enright, Arvind Kunadi, Thomas E Vanhecke
BACKGROUND: Routine management of patients with acute decompensated heart failure (ADHF) requires careful attentiveness to fluid status and diuretic treatment efficacy. New advances in ultrasound have made ultraportable echocardiography (UE) available to physicians for point-of-care use. The purpose of this study is to explore physiologic measures of intravascular fluid volume derived from UE and explore predictors of diuretic response in ADHF. METHODS: Various echocardiography imaging measurements, particularly diameter and collapse of inferior vena cava (IVC), were collected from 77 patients admitted with a primary diagnosis of ADHF...
2016: Clinical Medicine Insights. Cardiology
https://www.readbyqxmd.com/read/27921080/echo-and-bnp-serial-assessment-in-ambulatory-heart-failure-care-data-on-loop-diuretic-use-and-renal-function
#15
Frank Lloyd Dini, Anca Simioniuc, Erberto Carluccio, Stefano Ghio, Andrea Rossi, Paolo Biagioli, Gianpaolo Reboldi, Gian Giacomo Galeotti, Fei Lu, Cornelia Zara, Gillian Whalley, Pier Luigi Temporelli
We compared the follow-up data on loop diuretic use and renal function, as assessed by serum creatinine levels, and the estimated glomerular filtration rate (eGFR), of two groups of consecutive ambulatory HF patients: 1) the clinically-guided group, in which management was clinically driven based on the institutional protocol of the HF Unit of the Cardiovascular and Thoracic Department of Pisa (standard of care) and 2) the echo and B-type natriuretic peptide (BNP) guided group (patients conforming to the protocol of the Network Labs Ultrasound (NEBULA) in HF Study Group: Pisa, Perugia, Pavia; Verona, Auckland, and Veruno), in which therapy was delivered according to the serial assessment of BNP and echocardiography...
December 2016: Data in Brief
https://www.readbyqxmd.com/read/27918302/a-new-solvate-of-furosemide-with-dimethylacetamide
#16
Alina A Beloborodova, Vasily S Minkov, Elena V Boldyreva
The loop diuretic furosemide is used widely in the treatment of congestive heart failure and edema, and is practically insoluble in water. The physicochemical and pharmacokinetic properties of drugs can be modified by preparing the drug in an appropriate solid-state form. A new solvate of furosemide with dimethylacetamide (DMA) {systematic name: 4-chloro-2-[(furan-2-yl)methylamino]-5-sulfamoylbenzoic acid N,N-dimethylacetamide disolvate}, C12H11ClN2O5S·2C4H9NO, (I), is reported. The channeled structure formed on slow crystallization contains DMA solvent molecules in its channels...
December 1, 2016: Acta Crystallographica. Section C, Structural Chemistry
https://www.readbyqxmd.com/read/27899856/effect-of-spironolactone-on-plasma-apelin-12-levels-in-patients-with-chronic-systolic-heart-failure
#17
Mustafa Topuz, Mehmet Cosgun, Oğuz Akkuş, Atilla Bulut, Omer Sen, Ayşe Nur Topuz, Murat Caylı
BACKGROUND: The aim of this study was to determine whether spironolactone therapy has an effect on serum apelin-12 levels in heart failure with reduced ejection fraction (HFrEF) patients. METHODS: Eighty outpatients previously diagnosed with HFrEF were enrolled in the current study. Included patients were taking only standard heart failure therapy (ST) (angiotensin converting enzyme or angiotensin receptor blocker, beta-blockers, loop diuretics and anticoagulant or antiagregan agents) without a mineralocorticoid receptor antagonists (MRA) because of its side effects, and were designated the non-MRA group; those patients taking 25 mg/daily spironolactone in addition to the ST were deemed the MRA group...
November 2016: Acta Cardiologica Sinica
https://www.readbyqxmd.com/read/27883326/renal-replacement-therapy-in-patients-with-heart-and-kidney-failure
#18
Dimitrios S Goumenos, Evangelos Papachristou, Marios Papasotiriou
The incidence of chronic kidney disease (CKD) in patients with chronic heart failure (CHF) is high as CKD and CHF share underlying risk factors such as arterial hypertension, diabetes mellitus and atherosclerosis. Cardiac failure leads to renal hypoperfusion and dysfunction and then fluid overload and need for aggressive diuretic therapy. However, development of diuretic resistance represents a significant problem in the management of these patients. The role of Renal Replacement Therapy (RRT) is important for patients who do not response to conservative management of fluid overload facilitating the failing heart to restore function...
November 1, 2016: Prilozi (Makedonska Akademija Na Naukite i Umetnostite. Oddelenie za Medicinski Nauki)
https://www.readbyqxmd.com/read/27872700/pharmacokinetic-study-of-furosemide-incorporated-plga-microspheres-after-oral-administration-to-rat
#19
Katayoun Derakhshandeh, Moin Karimi, Abbas Hemati Azandaryani, Gholamreza Bahrami, Kiumras Ghanbari
OBJECTIVES: The purpose of the current study was to assess the feasibility of microspheres from biocompatible polymer for oral bioavailability (BA) enhancement of potent sulfonamide- type loop diuretic- Furosemide - which used in the treatment of congestive heart failure, caused edema, cirrhosis, renal disease and as an adjunct in acute pulmonary edema. The comparatively poor and inconstant BA of furosemide, which occurs site-specifically in the stomach and upper small intestine, has been ascribed to the poor dissolution of furosemide...
October 2016: Iranian Journal of Basic Medical Sciences
https://www.readbyqxmd.com/read/27865177/association-of-plasma-xanthine-oxidoreductase-activity-with-severity-and-clinical-outcome-in-patients-with-chronic-heart-failure
#20
Yoichiro Otaki, Tetsu Watanabe, Daisuke Kinoshita, Miyuki Yokoyama, Tetsuya Takahashi, Taku Toshima, Takayuki Sugai, Takayo Murase, Takashi Nakamura, Satoshi Nishiyama, Hiroki Takahashi, Takanori Arimoto, Tetsuro Shishido, Takuya Miyamoto, Isao Kubota
BACKGROUND: Oxidative stress due to purine degradation is associated with the development of chronic heart failure (CHF). Xanthine oxidoreductase (XOR) is a rate-limiting enzyme of purine degradation that plays a key role in uric acid (UA) production with a resultant increase in reactive oxygen species. However, the relationship between plasma XOR activity and CHF severity and clinical outcome remains unclear. METHODS AND RESULTS: We measured XOR activity in 440 patients with CHF and 44 control subjects...
February 1, 2017: International Journal of Cardiology
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