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Loop diuretic, heart failure

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https://www.readbyqxmd.com/read/27921080/echo-and-bnp-serial-assessment-in-ambulatory-heart-failure-care-data-on-loop-diuretic-use-and-renal-function
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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...
November 9, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27819111/cardiac-dysfunction-congestion-and-loop-diuretics-their-relationship-to-prognosis-in-heart-failure
#7
Pierpaolo Pellicori, John G F Cleland, Jufen Zhang, Anna Kallvikbacka-Bennett, Alessia Urbinati, Parin Shah, Syed Kazmi, Andrew L Clark
BACKGROUND: Diuretics are the mainstay of treatment for congestion but concerns exist that they adversely affect prognosis. We explored whether the relationship between loop diuretic use and outcome is explained by the underlying severity of congestion amongst patients referred with suspected heart failure. METHOD AND RESULTS: Of 1190 patients, 712 had a left ventricular ejection fraction (LVEF) ≤50 %, 267 had LVEF >50 % with raised plasma NTproBNP (>400 ng/L) and 211 had LVEF >50 % with NTproBNP ≤400 ng/L; respectively, 72 %, 68 % and 37 % of these groups were treated with loop diuretics including 28 %, 29 % and 10 % in doses ≥80 mg furosemide equivalent/day...
November 7, 2016: Cardiovascular Drugs and Therapy
https://www.readbyqxmd.com/read/27818782/randomized-pilot-trial-comparing-tolvaptan-with-furosemide-on-renal-and-neurohumoral-effects-in-acute-heart-failure
#8
Kentaro Jujo, Katsumi Saito, Issei Ishida, Yuho Furuki, Ahsung Kim, Yuki Suzuki, Haruki Sekiguchi, Junichi Yamaguchi, Hiroshi Ogawa, Nobuhisa Hagiwara
AIMS: Loop diuretics are first-line medications for congestive heart failure (CHF); however, they are associated with serious adverse effects, including decreased renal function, and sympathetic nervous and renin-angiotensin system activation. We tested whether tolvaptan, a vasopressin V2-receptor antagonist, could reduce unfavourable furosemide-induced effects during CHF treatment. METHODS AND RESULTS: Sixty patients emergently hospitalized owing to CHF-induced dyspnea were randomly assigned to receive either 40 mg intravenous furosemide daily or 7...
September 2016: ESC Heart Failure
https://www.readbyqxmd.com/read/27818309/telemonitoring-adherence-to-medications-in-heart-failure-patients-team-hf-a-pilot-randomized-clinical-trial
#9
Benjamin D Gallagher, Nathalie Moise, Mytra Haerizadeh, Siqin Ye, Vivian Medina, Ian M Kronish
BACKGROUND: Medication nonadherence contributes to hospitalizations in recently discharged patients with heart failure (HF). We aimed to test the feasibility of telemonitoring medication adherence in patients with HF. METHODS AND RESULTS: We randomized 40 patients (1:1) hospitalized for HF to 30 days of loop diuretic adherence monitoring with telephonic support or to passive adherence monitoring alone. Eighty-three percent of eligible patients agreed to participate...
November 3, 2016: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/27816115/implications-of-serum-chloride-homeostasis-in-acute-heart-failure-from-rose-ahf
#10
Justin L Grodin, Jie-Lena Sun, Kevin J Anstrom, Horng H Chen, Randall C Starling, Jeffrey M Testani, W H Wilson Tang
Lower serum chloride (Cl) levels are strongly associated with increased long-term mortality after admission for acute heart failure (AHF). However, the therapeutic implications of serum Cl levels during AHF are unknown. We sought to determine the short-term clinical response and postdischarge outcomes associated with serum Cl levels in AHF. Serum Cl was measured at randomization (n = 358) and during hospitalization from patients with AHF in the Renal Optimization Strategies Evaluation in Acute Heart Failure trial...
September 30, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/27791272/evaluation-of-the-predictors-of-readmission-in-korean-patients-with-heart-failure
#11
J E Chung, E Noh, H S Gwak
WHAT IS KNOWN AND OBJECTIVE: Various factors contribute to the high rate of readmission among patients hospitalized with heart failure (HF). Determination of these factors is fundamental to identify potential targets for intervention in hospitalized patients. METHODS: The retrospective cohort study used a large national insurance database to identify episodes of HF. Clinical information up to 12 months from the index hospitalization was obtained. Depending on their outcome, eligible patients were classified into a 30-day readmission group after discharge or a non-readmission group...
October 28, 2016: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/27789808/elevation-of-arginine-vasopressin-levels-following-loop-diuretic-therapy-as-a-prognostic-indicator-in-heart-failure
#12
Shuichi Kitada, Shohei Kikuchi, Hiroo Sonoda, Atsuhiro Yoshida, Nobuyuki Ohte
OBJECTIVE: To investigate the association between arginine vasopressin (AVP) levels and loop diuretic (LD) therapy in patients with heart failure and to determine if AVP levels are a prognostic indicator of treatment failure. METHODS: Patients with stable heart failure and reduced (< 40%) left ventricular ejection fraction (LVEF) were divided into those treated with (LD) or without LD (NLD). The LD group was separated into subgroups of high (> 6.5 pg/dl) and low (≤ 6...
October 26, 2016: Journal of International Medical Research
https://www.readbyqxmd.com/read/27772698/comparison-of-ambulatory-high-dose-intravenous-diuretic-therapy-to-standard-hospitalization-and-diuretic-therapy-for-treatment-of-acute-decompensated-heart-failure
#13
Leo F Buckley, Enrique Seoane-Vazquez, Judy W M Cheng, Ahmed Aldemerdash, Irene M Cooper, Lina Matta, Danika S Medina, Mandeep R Mehra, Kristina Navarro-Velez, Elaine L Shea, Joanne R Weintraub, Lynne W Stevenson, Akshay S Desai
Innovative treatment strategies for decompensated heart failure (HF) are required to achieve cost savings and improvements in outcomes. We developed a decision analytic model from a hospital perspective to compare 2 strategies for the treatment of decompensated HF, ambulatory diuretic infusion therapy, and hospitalization (standard care), with respect to total HF hospitalizations and costs. The ambulatory diuretic therapy strategy included outpatient treatment with high doses of intravenous loop diuretics in a specialized HF unit whereas standard care included hospitalization for intravenous loop diuretic therapy...
November 1, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/27754081/os-19-04-chronic-diuretic-therapy-does-not-impair-the-effectiveness-of-patiromer-in-hyperkalemic-patients-with-ckd
#14
Matthew Weir, Martha Mayo, Dahlia Garza, Susan Arthur, Lance Berman, David Bushinsky, Daniel Wilson, Murray Epstein
OBJECTIVE: Diuretics, alone or in combination, are frequently prescribed in chronic kidney disease (CKD) and heart failure (HF) patients to reduce volume, blood pressure, and/or for symptom control. Clinicians may also use them to reduce the risk of hyperkalemia, but high doses of diuretics may lead to adverse events from intravascular volume depletion or gout. Patiromer is a non-absorbed K-binding polymer recently approved by the FDA for the treatment of hyperkalemia (HK). We compared patiromer's effects in RAASi-treated CKD patients with HK on different types of diuretics to patients not receiving diuretics in the treatment phase of OPAL-HK...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27748700/acetazolamide-therapy-for-metabolic-alkalosis-in-pediatric-intensive-care-patients
#15
Carolina López, Andrés José Alcaraz, Blanca Toledo, Lucía Cortejoso, Maite Augusta Gil-Ruiz
OBJECTIVE: Patients in PICUs frequently present hypochloremic metabolic alkalosis secondary to loop diuretic treatment, especially those undergoing cardiac surgery. This study evaluates the effectiveness of acetazolamide therapy for metabolic alkalosis in PICU patients. DESIGN: Retrospective, observational study. SETTING: A tertiary care children's hospital PICU. PATIENTS: Children receiving at least a 2-day course of enteral acetazolamide...
December 2016: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/27726855/serum-potassium-levels-and-outcome-in-patients-with-chronic-heart-failure
#16
Sarah Hoss, Yair Elizur, David Luria, Andre Keren, Chaim Lotan, Israel Gotsman
Potassium levels are often abnormal in patients with heart failure (HF) and have a detrimental effect on clinical outcome. We evaluated potassium levels in a real-world cohort of patients with HF and its effect on mortality. All patients with a diagnosis of HF at a health maintenance organization were evaluated and followed for cardiac-related hospitalizations and death. The cohort consisted of 6,073 patients with HF. Mean potassium levels were 4.57 ± 0.53 mmol/L. Most patients (68%) had potassium levels in the normal range (4...
September 15, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/27706470/comparison-of-approaches-for-heart-failure-case-identification-from-electronic-health-record-data
#17
Saul Blecker, Stuart D Katz, Leora I Horwitz, Gilad Kuperman, Hannah Park, Alex Gold, David Sontag
Importance: Accurate, real-time case identification is needed to target interventions to improve quality and outcomes for hospitalized patients with heart failure. Problem lists may be useful for case identification but are often inaccurate or incomplete. Machine-learning approaches may improve accuracy of identification but can be limited by complexity of implementation. Objective: To develop algorithms that use readily available clinical data to identify patients with heart failure while in the hospital...
October 5, 2016: JAMA Cardiology
https://www.readbyqxmd.com/read/27706088/vasopressin-receptor-antagonists-for-the-correction-of-hyponatremia-in-chronic-heart-failure-an-underutilized-therapeutic-option-in-current-clinical-practice
#18
REVIEW
Renato De Vecchis, Claudio Cantatrione, Damiana Mazzei, Cesare Baldi
In the congestive heart failure (CHF) setting, chronic hyponatremia is very common. The present review aims at addressing topics relevant to the pathophysiology of hyponatremia in the course of CHF as well as its optimal treatment, including the main advantages and the limitations resulting from the use of the available dietary and pharmacological measures approved for the treatment of this electrolytic trouble. A narrative review is carried out in order to represent the main modalities of therapy for chronic hyponatremia that frequently complicates CHF...
October 2, 2016: Journal of Clinical Medicine
https://www.readbyqxmd.com/read/27690339/echo-and-natriuretic-peptide-guided-therapy-improves-outcome-and-reduces-worsening-renal-function-in-systolic-heart-failure-an-observational-study-of-1137-outpatients
#19
Anca Simioniuc, Erberto Carluccio, Stefano Ghio, Andrea Rossi, Paolo Biagioli, Gianpaolo Reboldi, Gian Giacomo Galeotti, Fei Lu, Cornelia Zara, Gillian Whalley, Pier Luigi Temporelli, Frank Lloyd Dini
BACKGROUND: B-type natriuretic peptide (BNP) and echocardiography are potentially useful adjunct to guide management of patients with chronic heart failure (HF).Thus, the aim of this retrospective, multicenter study was to compare outcomes and renal function in outpatients with chronic HF with reduced ejection fraction (HFrEF) who underwent an echo and BNP guided or a clinically driven protocol for follow-up. METHODS AND RESULTS: In 1137 consecutive outpatients, management was guided according to echo-Doppler signs of elevated left ventricular filling pressure and BNP levels conforming to the protocol of the Network Labs Ultrasound (NEBULA) in HF Study Group in 570 (mean EF=30%), while management was clinically driven based on the institutional protocol of the HF Unit of the Cardiovascular and Thoracic Department in 567 (mean EF=33%)...
December 1, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27669547/role-of-isolated-ultrafiltration-in-the-management-of-chronic-refractory-and-acute-decompensated-heart-failure
#20
Mayank K Mittal, Natraj Katta, Martin A Alpert
Chronic congestive heart failure (CHF) and acute decompensated heart failure (ADHF) refractory to medical therapy represent therapeutic challenges. In such patients, attempts to reduce pulmonary and systemic congestion frequently produce deterioration of renal function. In studies of patients with chronic severe CHF refractory to medical therapy (including loop diuretics), isolated ultrafiltration was frequently able to relieve congestive symptoms by precise removal of extracellular water and sodium, and in some cases was able to restore responsiveness to loop diuretics...
October 2016: Hemodialysis International
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