Comparative effects of long-acting and short-acting loop diuretics on cardiac sympathetic nerve activity in patients with chronic heart failure.
Open Heart
; 3(1): e000276, 2016.
Article
en En
| MEDLINE
| ID: mdl-26870386
ABSTRACT
OBJECTIVE:
Short-acting loop diuretics are known to enhance cardiac sympathetic nerve activity (CSNA) in patients with chronic heart failure (CHF). The effects of two loop diuretics-long-acting azosemide and short-acting furosemide-on CSNA were evaluated using (123)I-metaiodobenzylguanidine (MIBG) scintigraphy in patients with CHF.METHODS:
The present study was a subanalysis of our previously published study, which had reported that serial (123)I-MIBG studies were the most useful prognostic indicator in patients with CHF. Patients with CHF (n=208, left ventricular ejection fraction <45%) but no history of cardiac events for at least 5â months prior to the study were identified according to their histories of acute decompensated heart failure requiring hospitalisation. Patients underwent (123)I-MIBG scintigraphy immediately before hospital discharge and at a 6-month follow-up. The delayed % denervation, delayed heart/mediastinum count (H/M) ratio and washout rate (WR) were determined using (123)I-MIBG scintigraphy. A total of 108 patients were selected, and propensity score matching was used to compare patients treated with either oral azosemide (n=54) or furosemide (n=54).RESULTS:
After treatment, (123)I-MIBG scintigraphic parameters improved in both groups. However, the degree of change in % denervation was -13.8±10.5 in the azosemide group and -5.7±12.7 in the furosemide group (p<0.01), the change in H/M ratio was 0.20±0.16 in the azosemide group and 0.06±0.19 in the furosemide group (p<0.01), and the change in WR was -11.3±9.2% in the azosemide group and -3.0±12.7% in the furosemide group (p<0.01). Moreover, multivariate analysis showed an independent and significant positive relationship between furosemide and δ-WR from hospital discharge to 6â months after treatment in patients with CHF (p=0.001).CONCLUSIONS:
These findings indicate that azosemide suppresses CSNA compared with furosemide in patients with CHF. TRIAL REGISTRATION NUMBER UMIN000000626 (UMIN-CTR Clinical Trial).
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Tipo de estudio:
Prognostic_studies
Idioma:
En
Revista:
Open Heart
Año:
2016
Tipo del documento:
Article
País de afiliación:
Japón