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Loop diuretic, heart failure

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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
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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...
January 15, 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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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