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Loop diuretic, heart failure

Lukasz P Cerbin, Andrew P Ambrosy, Stephen J Greene, Paul W Armstrong, Javed Butler, Adrian Coles, Adam D DeVore, Justin A Ezekowitz, Adrian F Hernandez, Marco Metra, Randall C Starling, Wilson Tang, John R Teerlink, Adriaan A Voors, Angie Wu, Christopher M O'Connor, Robert J Mentz
OBJECTIVES: As the largest acute heart failure (AHF) trial conducted to date, the global ASCEND-HF (Acute Study of Clinical Effectiveness of Nesiritide in Decompensated Heart Failure) trial database presented an opportunity to systematically describe the relationship among time of hospital presentation, clinical profile, inpatient management, and outcomes among patients admitted with AHF. BACKGROUND: Time of hospital presentation has been shown to impact outcomes among patients hospitalized with many conditions...
March 7, 2018: JACC. Heart Failure
Masahiro Yamazoe, Atsushi Mizuno, Shun Kohsaka, Yasuyuki Shiraishi, Takashi Kohno, Ayumi Goda, Satoshi Higuchi, Mayuko Yagawa, Yuji Nagatomo, Tsutomu Yoshikawa
BACKGROUND: Diuretics are the cornerstone therapy for acute heart failure (AHF) but can lead to various electrolyte disturbances and inversely affect the patients' outcome. We aimed to evaluate whether (1) the dose of loop diuretics could predict hospital-acquired hyponatremia (HAH) during AHF treatment, (2) addition of thiazide diuretics could affect development of HAH, and (3) assess their impact on long-term outcomes. METHODS: We analyzed the subjects enrolled in the multicenter AHF registry (WET-HF)...
March 5, 2018: Journal of Cardiology
Md Shahidul Islam
It is important to understand the rationale for appropriate use of different diuretics, alone or in combination, in different heart failure patients, under diverse clinical settings. Clinicians and nurses engaged in heart failure care, must be familiar with different diuretics, their appropriate doses, methods of administration, monitoring of the responses, and the side-effects. Inappropriate use of diuretics, both under-treatment and overtreatment, and poor follow-up can lead to failures, and adverse outcomes...
March 3, 2018: Advances in Experimental Medicine and Biology
Justin L Grodin, Spencer Carter, Bradley A Bart, Steven R Goldsmith, Mark H Drazner, W H Wilson Tang
AIMS: Mechanical ultrafiltration (UF) involves the removal of an iso-osmotic filtrate from the blood. Its benefit in acute decompensated heart failure, however, remains inconclusive. We sought to better understand the direct effects of UF in comparison to an aggressive, urine output-guided pharmacological protocol for decongestion on fluid loss, renal function, and neurohormonal activation. METHODS AND RESULTS: A per-protocol analysis of the Cardiorenal Rescue Study in Acute Decompensated Heart Failure (CARRESS-HF) trial (n = 188) was performed...
March 1, 2018: European Journal of Heart Failure
Michael S Kiernan, Susanna R Stevens, W H Wilson Tang, Javed Butler, Kevin J Anstrom, Edo Y Birati, Justin L Grodin, Divya Gupta, Kenneth B Margulies, Shane LaRue, Victor G Dávila-Román, Adrian F Hernandez, Lisa de Las Fuentes
BACKGROUND: Poor response to loop diuretic therapy is a marker of risk during acute heart failure hospitalization. We sought to describe baseline determinants of diuretic response and to further explore the relationship between this response and clinical outcomes. METHODS AND RESULTS: Patient data from the NHLBI Heart Failure Network ROSE-AHF and CARRESS-HF clinical trials were analyzed to determine baseline determinants of diuretic response. Diuretic efficiency (DE) was defined as total 72h fluid output per total equivalent loop diuretic dose; subjects were stratified to high and low DE groups by the median value...
February 23, 2018: Journal of Cardiac Failure
Lei Lei, Yuanjie Mao
The common ultimate pathological feature for all cardiovascular diseases, congestive heart failure (CHF), is now considered as one of the main public health burdens that is associated with grave implications. Neurohormonal systems play a critical role in cardiovascular homeostasis, pathophysiology, and cardiovascular diseases. Hormone treatments such as the newly invented dual-acting drug valsartan/sacubitril are promising candidates for CHF, in addition to the conventional medications encompassing beta receptor blockers, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, and mineralocorticoid receptor antagonists...
January 1, 2018: Journal of International Medical Research
G Sakalauskienė, G Civinskienė, A Antuševas, P Civinskas
Edematous states caused by an excessesive extracellular fluid retention are major components of cardiovascular and renal disorders including chronic kidney disease, nephrotic syndrome, and heart failure. The use of diuretic drugs from various groups including loop duiretics are important means of pharmacological correction of these clinical conditions. Moreover, diuretics used to lower bood pressure as a part of antihypertensive treatment, reduce cardiovascular events. The response of patients to the dose of a diuretic is reflected by a sigmoid dose-response curve which can be affected by changes of sodium content in the body...
January 2018: Kardiologiia
Elizabeth K Pogge, Lindsay E Davis
OBJECTIVE: The objective of this research was to describe the use of pharmacist-managed sacubitril/valsartan therapy in a multi-center, outpatient cardiac group. BACKGROUND: Sacubitril/valsartan, an angiotensin receptor-neprilysin inhibitor (ARNi), is a novel agent for the treatment of heart failure. An ARNi is recommended by national guidelines to be used in place of angiotensin-converting enzyme inhibitor (ACEi) or angiotensin receptor blocker (ARB) therapy for patients who remain symptomatic...
February 17, 2018: American Journal of Cardiovascular Drugs: Drugs, Devices, and Other Interventions
P Z Szymanski, M Badri, B M Mayosi
BACKGROUND: There is limited information on acute heart failure (AHF) and its treatment in sub-Saharan Africa. OBJECTIVE: To describe the clinical characteristics and causes of heart failure (HF), adherence to HF treatment guidelines, and mortality of patients with AHF presenting to Groote Schuur Hospital (GSH), Cape Town, South Africa. METHODS: This sub-study of The Sub-Saharan Africa Survey of Heart Failure (THESUS-HF) was a prospective and observational survey that focused on the enrolment and follow-up of additional patients with AHF presenting to GSH and entered into the existing registry after publication of the primary THESUS-HF article in 2012...
February 1, 2018: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
Anna Kańtoch, Barbara Gryglewska, Jadwiga Wójkowska-Mach, Piotr Heczko, Tomasz Grodzicki
BACKGROUND: The prevalence of cardiovascular diseases among nursing home residents is high but little is known whether pharmacologic therapy recommended by actual medication guidelines is followed by facility's staff. AIM: To evaluate the adherence to actual guidelines for treatment of cardiovascular diseases among older adult residents of long-term care (LTC) facilities. MATERIAL AND METHODS: The cross-sectional study was performed from December 2009 to November 2010 among 189 elderly residents aged ≥60 years in 3 LTC facilities in Poland: 1 long-term care hospital (LTCH) and 2 nursing homes (NHs)...
February 2, 2018: Journal of the American Medical Directors Association
Makiko Nakamura, Osahiko Sunagawa, Koichiro Kinugawa
It is unknown whether a response to tolvaptan (TLV) is related to prognosis in patients with acute decompensated heart failure (ADHF). We selected 25 patients as responders by their urinary response to TLV and by reduction of loop diuretics from 37 consecutive ADHF patients treated with TLV. As a control group, we selected 25 patients from 100 consecutive ADHF patients who were not treated with TLV by propensity score matching for age, serum sodium level, serum creatinine level, plasma B-type natriuretic peptide (BNP) level, systolic blood pressure, heart rate, and dose of loop diuretics...
2018: International Heart Journal
Tariq Ahmad, Keyanna Jackson, Veena S Rao, W H Wilson Tang, Meredith A Brisco-Bacik, Horng H Chen, G Michael Felker, Adrian F Hernandez, Christopher M O'Connor, Venkata S Sabbisetti, Joseph V Bonventre, F Perry Wilson, Steven G Coca, Jeffrey M Testani
Background -Worsening renal function (WRF) in the setting of aggressive diuresis for acute heart failure (AHF) treatment may reflect renal tubular injury or simply indicate a hemodynamic or functional change in glomerular filtration. Well-validated tubular injury biomarkers-NAG, NGAL, and KIM-1- are now available that can quantify the degree of renal tubularinjury. The ROSE-AHF trial provides an experimental platform for the study of mechanisms of WRF during aggressive diuresis for AHF, as the ROSE-AHF protocol dictated high dose loop diuretic therapy in all patients...
January 19, 2018: Circulation
R De Vecchis, C Ariano, G Di Biase, M Noutsias
BACKGROUND: The combination drug sacubitril/valsartan was reported to be superior to enalapril in reducing all-cause death, cardiovascular mortality, and heart failure (HF) hospitalizations in patients with cardiac insufficiency and reduced left ventricular ejection fraction (HFREF) with NYHA class II-IV. METHODS: Our retrospective cohort study aimed to assess the effects of sacubitril/valsartan in addition to a beta-blocker and mineral receptor antagonist (MRA) in a group of HFREF patients with NYHA class II-III HF vs...
January 19, 2018: Herz
Yusuke Nakano, Tomofumi Mizuno, Toru Niwa, Kentaro Mukai, Hirokazu Wakabayashi, Atsushi Watanabe, Hirohiko Ando, Hiroaki Takashima, Kenta Murotani, Katsuhisa Waseda, Tetsuya Amano
Tolvaptan (TLV) has an inhibiting effect for worsening renal function (WRF) in acute decompensated heart failure (HF) patients. However, there are limited data regarding the effect of continuous TLV administration on medium-term WRF.This was a retrospective observational study in hospitalized HF patients with chronic kidney disease (CKD). TLV was administered to those patients with fluid retention despite standard HF therapy. We compared 34 patients treated with TLV (TLV group) to 33 patients treated with conventional HF therapy with high-dose loop diuretics (furosemide ≥ 40 mg) (Loop group)...
January 15, 2018: International Heart Journal
David Montero, Thomas Haider
No abstract text is available yet for this article.
January 8, 2018: European Heart Journal. Cardiovascular Pharmacotherapy
Surya Ayalasomayajula, Uwe Schuehly, Parasar Pal, Fabian Chen, Wei Zhou, Gangadhar Sunkara, Thomas H Langenickel
AIMS: Sacubitril/valsartan is indicated for the treatment of heart failure and reduced ejection fraction (HFrEF). Furosemide, a loop diuretic commonly used for the treatment of HFrEF, may be coadministered with sacubitril/valsartan in clinical practice. The effect of sacubitril/valsartan on the pharmacokinetics and pharmacodynamics of furosemide was evaluated in this open label, two-period, single-sequence study in healthy subjects. METHODS: All subjects (n = 28) received 40 mg oral single-dose furosemide during period 1, followed by a washout of 2 days...
January 9, 2018: British Journal of Clinical Pharmacology
Ken Lee Chin, Marina Skiba, Christopher M Reid, Andrew Tonkin, Ingrid Hopper, Justin A Mariani, Danny Liew
PURPOSE: Previous studies on the 'treatment gap' in patients with heart failure (HF) have focused either on prescribing or patients' adherence to prescribed treatment. This study sought to determine whether or not recent initiatives to close the gap have also minimised any mismatches between physicians' expectation of their patients' medications, medications in the patients' possession and their actual medication use. METHODS: A cross-sectional observational survey was conducted from December 2015 to June 2016 in The Alfred Hospital HF clinic in Melbourne, Australia...
January 9, 2018: Cardiovascular Drugs and Therapy
Steven R Goldsmith, Bradley A Bart, Ileana L Piña
Decompensated or acute heart failure (AHF) is characterized by increased ventricular and atrial pressures which may lead to and be caused by circulatory congestion. Unless due to a primary decrease in cardiac function, congestion arises from volume expansion or vasoconstriction. In turn, volume expansion and vasoconstriction are due to neurohormonal imbalance since both result from activation of the sympathetic nervous system, the renin-angiotensin-aldosterone axis and excess secretion of arginine vasopressin...
December 16, 2017: Current Problems in Cardiology
Gary S Francis, Tamas Alexy
No abstract text is available yet for this article.
January 2018: JACC. Heart Failure
Priscila Raupp da Rosa, Luis E Rohde, Madeni Doebber, Antonio L P Ribeiro, Deborah P Prado, Eduardo G Bertoldi, Jose A Figueiredo Neto, Ilmar Kohler, Luis Beck-da-Silva, Luiz C Danzmann, Lidia Zytynski Moura, Marciane Rover, Marcus V Simões, Roberto T Sant'Anna, Andréia Biolo
AIMS: Furosemide is commonly prescribed for symptom relief in heart failure (HF) patients. Although few data support the continuous use of loop diuretics in apparently euvolemic HF patients with mild symptoms, there is concern about safety of diuretic withdrawal in these patients. The ReBIC-1 trial was designed to evaluate the safety and tolerability of withdrawing furosemide in stable, euvolemic, chronic HF outpatients. This multicenter initiative is part of the Brazilian Research Network in Heart Failure (ReBIC) created to develop clinical studies in HF and composed predominantly by university tertiary care hospitals...
December 2017: American Heart Journal
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