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Loop diuretic, heart failure

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https://www.readbyqxmd.com/read/28645802/comparative-effects-of-long-and-short-acting-loop-diuretics-on-mortality-in-patients-with-chronic-heart-failure
#1
Shu Kasama, Takuji Toyama, Masahiko Kurabayashi
BACKGROUND: We previously reported that the long-acting loop diuretic azosemide improves cardiac sympathetic nerve activity (CSNA) in patients with chronic heart failure (CHF), compared with short-acting furosemide. However, its influence on mortality has not been determined. METHODS: The present study was a further analysis of our previously published study in which azosemide showed improved (123)I-metaiodobenzylguanidine scintigraphic findings compared with furosemide in CHF patients with reduced left ventricular ejection fraction (LVEF)...
June 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28641794/time-to-furosemide-treatment-and-mortality-in-patients-hospitalized-with-acute-heart-failure
#2
Yuya Matsue, Kevin Damman, Adriaan A Voors, Nobuyuki Kagiyama, Tetsuo Yamaguchi, Shunsuke Kuroda, Takahiro Okumura, Keisuke Kida, Atsushi Mizuno, Shogo Oishi, Yasutaka Inuzuka, Eiichi Akiyama, Ryuichi Matsukawa, Kota Kato, Satoshi Suzuki, Takashi Naruke, Kenji Yoshioka, Tatsuya Miyoshi, Yuichi Baba, Masayoshi Yamamoto, Koji Murai, Kazuo Mizutani, Kazuki Yoshida, Takeshi Kitai
BACKGROUND: Acute heart failure (AHF) is a life-threatening disease requiring urgent treatment, including a recommendation for immediate initiation of loop diuretics. OBJECTIVES: The authors prospectively evaluated the association between time-to-diuretic treatment and clinical outcome. METHODS: REALITY-AHF (Registry Focused on Very Early Presentation and Treatment in Emergency Department of Acute Heart Failure) was a prospective, multicenter, observational cohort study that primarily aimed to assess the association between time to loop diuretic treatment and clinical outcome in patients with AHF admitted through the emergency department (ED)...
June 27, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28633650/effects-of-tolvaptan-in-patients-with-acute-heart-failure-a-systematic-review-and-meta-analysis
#3
Chunbin Wang, Bo Xiong, Lin Cai
BACKGROUND: Acute heart failure, which requires urgent evaluation and treatment, is a leading cause for admission to the emergency department. The aim of this meta-analysis was to evaluate the effects of tolvaptan on acute heart failure and compare them with the effects of conventional therapy or placebo. METHODS: The electronic databases PubMed, EMBASE, and the Cochrane Controlled Trial registry were searched from their starting dates to October 24, 2016. Two authors independently read the trials and extracted related information from the included studies...
June 20, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28633477/loop-diuretics-for-chronic-heart-failure-a-foe-in-disguise-of-a-friend
#4
Chris J Kapelios, Konstantinos Malliaras, Elisabeth Kaldara, Stella Vakrou, John N Nanas
Loop diuretics are recommended for relieving symptoms and signs of congestion in patients with chronic heart failure and are administered to more than 80% of them. However, several of their effects have not systematically been studied. Numerous cohort and four interventional studies have addressed the effect of diuretics on renal function; apart from one prospective study, which showed that diuretics withdrawal is accompanied by increase in some markers of early-detected renal injury, all others converge to the conclusion that diuretics receipt, especially in high doses is associated with increased rates of renal dysfunction...
June 19, 2017: European Heart Journal. Cardiovascular Pharmacotherapy
https://www.readbyqxmd.com/read/28602369/heart-failure-complicating-acute-mtyocardial-infarction
#5
REVIEW
Wilbert S Aronow
Factors predisposing the older person with acute myocardial infarction (MI) to develop heart failure (HF) include an increased prevalence of MI, multivessel coronary artery disease, decreased left ventricular (LV) contractile reserve, impairment of LV diastolic relaxation, increased hypertension, LV hypertrophy, diabetes mellitus, valvular heart disease, and renal insufficiency. HF associated with acute MI should be treated with a loop diuretic. The use of nitrates, angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, aldosterone antagonists, beta-blockers, digoxin, and positive inotropic drugs; treatment of arrhythmias and mechanical complications; and indications for use of implantable cardioverter-defibrillators and cardiac resynchronization is discussed...
July 2017: Heart Failure Clinics
https://www.readbyqxmd.com/read/28597798/ultrafiltration-versus-intravenous-loop-diuretics-in-patients-with-acute-decompensated-heart-failure-a-meta-analysis-of-clinical-trials
#6
Mohamad Kabach, Hassan Alkhawam, Sachil Shah, Georges Joseph, Elie M Donath, Noah Moss, Robert S Rosenstein, Robert Chait
Background Intravenous loop diuretics are the first-line therapy for acute decompensated heart failure (ADHF) but many patients are discharged with unresolved congestion resulting in higher re-hospitalization and mortality rates. Ultrafiltration (UF) is a promising intervention for ADHF. However, studies comparing UF to diuretics have been inconsistent in their clinical outcomes. Methods A comprehensive literature search was performed. Trials were included if they met the following criteria: (1) randomization with a control group, (2) comparison of UF with a loop diuretic, and (3) a diagnosis of ADHF...
April 2017: Acta Cardiologica
https://www.readbyqxmd.com/read/28572743/design-and-rationale-of-the-high-sensitivity-troponin-t-rules-out-acute-cardiac-insufficiency-trial
#7
Benton R Hunter, Sean P Collins, Gregory J Fermann, Phillip D Levy, Changyu Shen, Syed Imran Ayaz, Mette L Cole, Karen F Miller, Adam A Soliman, Peter S Pang
BACKGROUND: Acute heart failure (AHF) is a common presentation in the Emergency Department (ED), and most patients are admitted to the hospital. Identification of patients with AHF who have a low risk of adverse events and are suitable for discharge from the ED is difficult, and an objective tool would be useful. METHODS: The highly sensitive Troponin T Rules Out Acute Cardiac Insufficiency Trial (TACIT) will enroll ED patients being treated for AHF. Patients will undergo standard ED evaluation and treatment...
2017: Pragmatic and Observational Research
https://www.readbyqxmd.com/read/28552097/community-acquired-staphylococcus-aureus-bacteremia-studies-of-risk-and-prognosis-with-special-attention-to-diabetes-mellitus-and-chronic-heart-failure
#8
Jesper Smit
Community-acquired Staphylococcus aureus bacteremia (CA-SAB) is a serious infection with detrimental clinical effects. Chronic diseases constitute some of the most important risk and prognostic factors for CA-SAB. The prevalence of diabetes and chronic heart failure (CHF) is rapidly increasing on a global scale, nevertheless, there are few data available specifically elucidating the influence of these chronic conditions on CA-SAB risk and outcome. Therefore, to extend the current knowledge, we aimed to I) elucidate the impact of different definitions of healthcare-associated (HCA) infection on the prevalence of HCA-SAB, patient characteristics, and mortality, II) to investigate whether diabetes is a risk factor for CA-SAB, III) to ascertain the prognostic influence of diabetes on CA-SAB outcome, and IV) to investigate the influence of CHF on mortality in patients with CA-SAB...
May 2017: Danish Medical Journal
https://www.readbyqxmd.com/read/28545850/renal-response-to-intravascular-volume-expansion-in-euvolemic-heart-failure-patients-with-reduced-ejection-fraction-mechanistic-insights-and-clinical-implications
#9
Petra Nijst, Frederik H Verbrugge, Pieter Martens, Matthias Dupont, W H Wilson Tang, Wilfried Mullens
BACKGROUND: Untreated and preclinical heart failure patients with reduced ejection fraction (HFrEF) have an impaired ability to alleviate excess intravascular volume. OBJECTIVES: To investigate 1) the renal response to intravascular volume expansion in euvolemic and optimally treated HFrEF patients and 2) loop diuretic efficiency. METHODS: 14 healthy and 28 HFrEF patients underwent intravascular volume expansion with 1l hydroxyl ethyl starch 6% during 3h after which a loop diuretic was administered...
May 14, 2017: International Journal of Cardiology
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
#10
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...
July 15, 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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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...
August 15, 2017: International Journal of Cardiology
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