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Loop diuretic, heart failure

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https://www.readbyqxmd.com/read/28532770/changes-in-loop-diuretic-dose-and-outcome-after-cardiac-resynchronization-therapy-in-patients-with-heart-failure-and-reduced-left-ventricular-ejection-fractions
#1
Pieter Martens, Frederik H Verbrugge, Petra Nijst, Matthias Dupont, Wilfried Mullens
Cardiac resynchronization therapy (CRT) improves cardiac hemodynamics. Therefore, the maintenance dose of loop diuretic therapy might be reduced. Consecutive patients who underwent CRT (n = 648) were retrospectively evaluated. Loop diuretic dose was recorded at baseline before implantation and 6 months later with patients classified into 4 groups: (1) no loop diuretic, (2) down-titration, (3) unchanged dose, and (4) up-titration. Afterward total loop diuretic exposure was calculated. Renal function trajectories were evaluated as the difference between implantation and censoring serum creatinine (Cr) value...
April 27, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28515029/tolvaptan-utilization-in-children-with-chronic-hyponatremia-due-to-inappropriate-antidiuretic-hormone-secretion-siadh-three-case-reports-and-review-of-the-literature
#2
Gerdi Tuli, Daniele Tessaris, Luisa De Sanctis, Patrizia Matarazzo
Hyponatremia is the most common electrolyte disorder among hospitalized patients and it is sometimes considered as a poor outcome predictor. Its correction is thus indicated, even in asymptomatic patients. The conventional treatment is represented by fluid restriction in presence of euvolemia or hypervolemia; whereas loop diuretics are used in some hypervolemic conditions (cardiac heart failure, liver cirrhosis and nephrotic syndrome) and intravenous isotonic or hypertonic solution are administered in hypovolemic conditions...
May 17, 2017: Journal of Clinical Research in Pediatric Endocrinology
https://www.readbyqxmd.com/read/28484958/markers-of-diuretic-resistance-in-emergency-department-patients-with-acute-heart-failure
#3
Andrew Doering, Cathy A Jenkins, Alan B Storrow, JoAnn Lindenfeld, Gregory J Fermann, Karen F Miller, Matthew Sperling, Sean P Collins
BACKGROUND: Loop diuretics are common therapy for emergency department (ED) patients with acute heart failure (AHF). Diuretic resistance (DR) is a term used to describe blunted natriuretic response to loop diuretics. It would be important to detect DR prior to it becoming clinically apparent, so early interventions can be initiated. However, several definitions have been proposed, and it is not clear if they identify similar patients. We compared these definitions and described the clinical characteristics of patients who fulfilled them...
December 2017: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28484118/effects-of-tolvaptan-with-or-without-the-pre-administration-of-renin-angiotensin-system-blockers-in-hospitalized-patients-with-acute-decompensated-heart-failure
#4
Sen Adachi, Shin-Ichiro Miura, Yuhei Shiga, Tadaaki Arimura, Joji Morii, Takashi Kuwano, Ken Kitajima, Atsushi Iwata, Natsumi Morito, Kanta Fujimi, Eiji Yahiro, Hiroaki Nishikawa, Keijiro Saku
We examined whether tolvaptan combined with an angiotensin II receptor blocker (ARB) or angiotensin converting enzyme inhibitor (ACE-I) is more effective than tolvaptan alone in the treatment of patients with heart failure (HF). Sixty-five hospitalized patients with acute decompensated HF were included in this study. They were divided into 2 groups; an ARB/ACE-I group (n = 44, who received ARB or ACE-I before the use of tolvaptan) and a non-ARB/ACE-I group (n = 21). There were no significant differences in patient characteristics including medications at baseline between the non-ARB/ACE-I and ARB/ACE-I groups with the exception of the percentages of hypertension and ischemic heart disease...
May 8, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28475215/effect-of-inpatient-dobutamine-vs-milrinone-on-out-of-hospital-mortality-in-patients-with-acute-decompensated-heart-failure
#5
Jordan B King, Rashmee U Shah, Amy Sainski-Nguyen, Joseph Biskupiak, Mark A Munger, Adam P Bress
STUDY OBJECTIVE: To determine the effect of dobutamine versus milrinone on out-of-hospital mortality in treatment of patients with acute decompensated heart failure (ADHF). DESIGN: Propensity score weighted, retrospective cohort study with mortality as primary outcome. SETTING: An academic health-care system. PATIENTS: 500 adult patients with a prior history of heart failure, who survived a hospitalization for ADHF that included treatment with dobutamine or milrinone between January 1, 2006 and April 30, 2014...
May 5, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28451449/benefit-of-tolvaptan-in-the-management-of-hyponatraemia-in-patients-with-diuretic-refractory-congestive-heart-failure-the-semi-sec-project
#6
Antonio Pose, Luis Almenar, Juan José Gavira, Amador López-Granados, Teresa Blasco, Juan Delgado, Oscar Aramburu, Avelino Rodríguez, Luis Manzano, Nicolás Manito
AIMS: Hyponatraemia is an electrolyte disorder that occurs in advanced congestive heart failure (HF) and worsens prognosis. We explored the usefulness of tolvaptan, which has shown promising results in the treatment of this condition. METHODS AND RESULTS: This study is based on a retrospective national registry (2011-15) of patients hospitalized with refractory HF and hyponatraemia who agreed to receive tolvaptan when standard treatment was ineffective. The benefit of tolvaptan was analysed according to the following criteria: normalization ([Na(+)] ≥ 135 mmol/L) or increased sodium levels [Na(+)] ≥ 4 mEq/L on completion of treatment, and increase in urine output by 300 or 500 mL at 48 h...
May 2017: ESC Heart Failure
https://www.readbyqxmd.com/read/28438307/usefulness-of-the-combination-of-in-hospital-poor-diuretic-response-and-systemic-congestion-to-predict-future-cardiac-events-in-patients-with-acute-decompensated-heart-failure
#7
Soichiro Aoki, Takahiro Okumura, Akinori Sawamura, Katsuhide Kitagawa, Ryota Morimoto, Masaki Sakakibara, Toyoaki Murohara
We aimed to (1) investigate the relation between diuretic response (DR) with or without systemic congestion and prognosis and (2) explore the potential predictors of poor DR for risk stratification in patients with acute decompensated heart failure (ADHF). We enrolled 186 consecutive patients hospitalized for ADHF. The DR was defined as (body weight at discharge - body weight at admission)/40 mg furosemide or equivalent loop diuretic dose. Systemic congestion on admission was simply evaluated by the presence of leg edema or jugular venous distention...
March 29, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28432473/vasopressin-and-vasopressin-antagonists-in-heart-failure
#8
Julie K Vishram-Nielsen, Finn Gustafsson
Despite the introduction of multiple new pharmacological agents over the past three decades in the field of heart failure (HF), overall prognosis remains poor. Hyponatremia is prevalent in HF patients and has been suggested as a contributor to poor response to standard therapy. Elevated levels of arginine vasopressin (AVP), a peptide hormone produced in the hypothalamus, play a role in development of hyponatremia, and AVP and its surrogate, copeptin, are related to changes in osmolality, hemodynamics, neuro-hormones as well as in overall outcome in HF patients...
April 22, 2017: Handbook of Experimental Pharmacology
https://www.readbyqxmd.com/read/28417963/loop-diuretics-affect-skeletal-myoblast-differentiation-and-exercise-induced-muscle-hypertrophy
#9
Shintaro Mandai, Susumu Furukawa, Manami Kodaka, Yutaka Hata, Takayasu Mori, Naohiro Nomura, Fumiaki Ando, Yutaro Mori, Daiei Takahashi, Yuki Yoshizaki, Yuri Kasagi, Yohei Arai, Emi Sasaki, Sayaka Yoshida, Yasuro Furuichi, Nobuharu L Fujii, Eisei Sohara, Tatemitsu Rai, Shinichi Uchida
Muscle wasting or sarcopenia contributes to morbidity and mortality in patients with cancer, renal failure, or heart failure, and in elderly individuals. Na(+)-K(+)-2Cl(-) cotransporter 1 (NKCC1) is highly expressed in mammalian skeletal muscle, where it contributes to the generation of membrane ion currents and potential. However, the physiologic function of NKCC1 in myogenesis is unclear. We investigated this issue using the NKCC1 inhibitors bumetanide and furosemide, which are commonly used loop diuretics...
April 18, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28409010/specialist-intervention-is-associated-with-improved-patient-outcomes-in-patients-with-decompensated-heart-failure-evaluation-of-the-impact-of-a-multidisciplinary-inpatient-heart-failure-team
#10
Jayne Masters, Geraint Morton, Isabel Anton, Jane Szymanski, Elizabeth Greenwood, Joanna Grogono, Andrew S Flett, John G F Cleland, Peter J Cowburn
OBJECTIVE: The study aimed to evaluate the impact of a multidisciplinary inpatient heart failure team (HFT) on treatment, hospital readmissions and mortality of patients with decompensated heart failure (HF). METHODS: A retrospective service evaluation was undertaken in a UK tertiary centre university hospital comparing 196 patients admitted with HF in the 6 months prior to the introduction of the HFT (pre-HFT) with all 211 patients seen by the HFT (post-HFT) during its first operational year...
2017: Open Heart
https://www.readbyqxmd.com/read/28392080/an-exploratory-analysis-of-the-competing-effects-of-aggressive-decongestion-and-high-dose-loop-diuretic-therapy-in-the-dose-trial
#11
Jennifer S Hanberg, W H Wilson Tang, F Perry Wilson, Steven G Coca, Tariq Ahmad, Meredith A Brisco, Jeffrey M Testani
BACKGROUND: Effective decongestion of heart failure patients predicts improved outcomes, but high dose loop diuretics (HDLD) used to achieve diuresis predict adverse outcomes. In the DOSE trial, randomization to a HDLD intensification strategy (HDLD-strategy) improved diuresis but not outcomes. Our objective was to determine if potential beneficial effects of more aggressive decongestion may have been offset by adverse effects of the HDLD used to achieve diuresis. METHODS AND RESULTS: A post hoc analysis of the DOSE trial (n=308) was conducted to determine the influence of post-randomization diuretic dose and fluid output on the rate of death, rehospitalization or emergency department visitation associated with the HDLD-strategy...
March 27, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28390907/prognostic-effect-of-the-dose-of-loop-diuretic-over-five-years-in-chronic-heart-failure
#12
Olga Laszczyńska, Milton Severo, Fernando Friões, Patrícia Lourenço, Sérgio Silva, Paulo Bettencourt, Nuno Lunet, Ana Azevedo
BACKGROUND: -High diuretic doses in chronic heart failure (HF) are potentially deleterious. We assessed the effect of dynamic furosemide dose on all-cause mortality among HF ambulatory patients. METHODS AND RESULTS: -A cohort of 560 ambulatory patients from an outpatient clinic specialized in HF, with median age 70 years, 67% male, 89% with moderate-severely reduced ejection fraction, was retrospectively followed for up to 5 years. Dynamic furosamide exposure was categorized as low (0-59 mg/d), medium (60-119 mg/d), high (120-159 mg/d) and very high (≥160 mg/d)...
April 5, 2017: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/28376668/validation-of-heart-failure-diagnosis-registered-in-primary-care-records-in-two-primary-care-centres-in-barcelona-spain-and-factors-related-a-cross-sectional-study
#13
Jose María Verdú-Rotellar, Eva Frigola-Capell, Rosa Alvarez-Pérez, Daniela da Silva, Cristina Enjuanes, Mar Domingo, Amparo Mena, Miguel-Angel Muñoz
BACKGROUND: Heart failure (HF) diagnosis as reported in primary care medical records is not always properly confirmed and could result in over-registration. OBJECTIVES: To determine the proportion of registered HF that can be confirmed with information from primary care medical records and to analyse related factors. METHODS: A cross-sectional study. The medical records of 595 HF patients attended in two primary healthcare centres in Barcelona (Spain) were revised and validated by a team of experts who classified diagnosis into confirmed, unconfirmed, and misdiagnosis...
December 2017: European Journal of General Practice
https://www.readbyqxmd.com/read/28356904/clinical-utility-of-patiromer-sodium-zirconium-cyclosilicate-and-sodium-polystyrene-sulfonate-for-the-treatment-of-hyperkalemia-an-evidence-based-review
#14
REVIEW
Mario V Beccari, Calvin J Meaney
INTRODUCTION: Hyperkalemia is a serious medical condition that often manifests in patients with chronic kidney disease and heart failure. Renin-angiotensin-aldosterone system inhibitors are known to improve outcomes in these disease states but can also cause drug-induced hyperkalemia. New therapeutic options exist for managing hyperkalemia in these patients which warrant evidence-based evaluation. AIM: The objective of this article was to review the efficacy and safety evidence for patiromer, sodium zirconium cyclosilicate (ZS9), and sodium polystyrene sulfonate (SPS) for the treatment of hyperkalemia...
2017: Core Evidence
https://www.readbyqxmd.com/read/28340405/population-pharmacokinetic-modeling-of-furosemide-in-patients-with-hypertension-and-fluid-overload-conditions
#15
Devender Kodati, Narsimhareddy Yellu
BACKGROUND: Furosemide is a loop diuretic drug frequently indicated in hypertension and fluid overload conditions such as congestive heart failure and hepatic cirrhosis. OBJECTIVE: The purpose of the study was to establish a population pharmacokinetic model for furosemide in Indian hypertensive and fluid overload patients, and to evaluate effects of covariates on the volume of distribution (V/F) and oral clearance (CL/F) of furosemide. METHODS: A total of 188 furosemide plasma sample concentrations from 63 patients with hypertension or fluid overload conditions were collected in this study...
June 2017: Pharmacological Reports: PR
https://www.readbyqxmd.com/read/28321027/effects-of-long-acting-loop-diuretics-in-heart-failure-with-reduced-ejection-fraction-patients-with-cardiac-resynchronization-therapy
#16
RANDOMIZED CONTROLLED TRIAL
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...
April 6, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28302060/heart-failure-labelled-patients-with-missing-ejection-fraction-in-primary-care-prognosis-and-determinants
#17
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
#18
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
#19
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
#20
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
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