Effects of intravenous furosemide plus small‐volume hypertonic saline solutions on markers of heart failure

Tuttolomondo, Antonino; Maida, Carlo; Casuccio, Alessandra; Raimondo, Domenico Di; Fonte, R.; Vassallo, Valerio; Puleo, Maria Grazia; Chiara, Tiziana Di; Mogavero, A.; Cuore, Alessandro Del; Daidone, Mario; Ortello, Antonella; Pinto, Antonio

doi:10.1002/ehf2.13511

Cited by 11 publications

(14 citation statements)

References 50 publications

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“…The concentration of proinflammatory cytokines, i.e., TNFα and IL-6 measured in supernatants of human peripheral blood mononuclear cells of a patient with chronic heart failure were inhibited in a dose-dependent manner by furosemide treatment [ 19 , 51 ].…”

Section: Discussionmentioning

confidence: 99%

Anti-Inflammatory Activities of Captopril and Diuretics on Macrophage Activity in Mouse Humoral Immune Response

Bryniarski

Nazimek

Marcinkiewicz

2021

IJMS

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Hypertension is accompanied by the over-activation of macrophages. Diuretics administered alone or in combination with hypotensive drugs may have immunomodulatory effects. Thus, the influence of tested drugs on mouse macrophage-mediated humoral immunity was investigated. Mice were treated intraperitoneally with captopril (5 mg/kg) with or without hydrochlorothiazide (10 mg/kg) or furosemide (5 mg/kg) by 8 days. Mineral oil-induced peritoneal macrophages were harvested to assess the generation of cytokines in ELISA, and the expression of surface markers was analyzed cytometrically. Macrophages were also pulsed with sheep red blood cells (SRBC) and transferred to naive mice for evaluation of their ability to induce a humoral immune response. Tested drugs increase the expression of surface markers important for the antigen phagocytosis and presentation. SRBC-pulsed macrophages from mice treated with captopril combined with diuretics increased the secretion of antigen-specific antibodies by recipient B cells, while macrophages of mice treated with hydrochlorothiazide or furosemide with captopril increased the number of antigen-specific B cells. Tested drugs alter the macrophage secretory profile in favor of anti-inflammatory cytokines. Our results showed that diuretics with or without captopril modulate the humoral response by affecting the function of macrophages, which has significant translational potential in assessing the safety of antihypertensive therapy.

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Section: Discussionmentioning

confidence: 99%

Anti-Inflammatory Activities of Captopril and Diuretics on Macrophage Activity in Mouse Humoral Immune Response

Bryniarski

Nazimek

Marcinkiewicz

2021

IJMS

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“…In recent years, association between loop diuretics and hypertonic saline solutions in the management of heart failure and associated hyponatremia became an area of interest in many studies. Tuttolomondo A. et al, observed that administration of a high dose of furosemide in association with hypertonic saline solution led to a decrease in natriuretic peptide and cytokine plasma levels (TNF-α, IL-1β, IL-6) [ 53 ]. Griffin M. et al, made a retrospective analysis in patients receiving 150 mL of 3% NaCl over 30 min, administered simultaneously with high doses of loop diuretics.…”

Section: Treatment Of Dilutional Hyponatremiamentioning

confidence: 99%

Management of Hyponatremia in Heart Failure: Practical Considerations

Șorodoc

Asaftei

Puha

et al. 2023

JPM

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Hyponatremia is commonly encountered in the setting of heart failure, especially in decompensated, fluid-overloaded patients. The pathophysiology of hyponatremia in patients with heart failure is complex, including numerous mechanisms: increased activity of the sympathetic nervous system and the renin–angiotensin–aldosterone system, high levels of arginine vasopressin and diuretic use. Symptoms are usually mild but hyponatremic encephalopathy can occur if there is an acute decrease in serum sodium levels. It is crucial to differentiate between dilutional hyponatremia, where free water excretion should be promoted, and depletional hyponatremia, where administration of saline is needed. An inappropriate correction of hyponatremia may lead to osmotic demyelination syndrome which can cause severe neurological symptoms. Treatment options for hyponatremia in heart failure, such as water restriction or the use of hypertonic saline with loop diuretics, have limited efficacy. The aim of this review is to summarize the principal mechanisms involved in the occurrence of hyponatremia, to present the main guidelines for the treatment of hyponatremia, and to collect and analyze data from studies which target new treatment options, such as vaptans.

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“…Tuttolomondo A, et al [14] Effects of intravenous furosemide plus small-volume hypertonic saline solutions on markers of heart failure R: 141…”

Section: Kitzman Dw Et Al [213]mentioning

confidence: 99%

Heart Failure (HF): Recent innovations in clinical therapy and critical profiles of acute and chronic forms

Perrotta¹

2022

J Cardiovasc Med Cardiol

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Background and objectives: Heart failure is a pathological condition characterized by the inability of the heart to pump (cardiac output) an adequate amount of blood to meet the metabolic needs of the body or, at any rate, to be able to do so only at the expense of increased filling pressures in one or more cardiac chambers and the upstream venous circulation. The research group states here the primary objective of expanding the indications contained in the ESC 2021 with the results of the last year on the subject of treatment profiles, to facilitate a better understanding of the overall clinical picture and contribute to the next edition of the guidelines. Materials and methods: Systematic literature review in the English language from January 1, 2021, to September 30, 2022, on PubMed/MedLine, Web on Science, and Cochrane archive. Our search strategy retrieved 8,317 articles. We excluded books and papers, meta-analyses, reviews, and systematic reviews and selected only 46 studies most significant about the clinical trial and randomized controlled trial. Results: The recent ESC 2021 guidelines are accurate and timely, and have confirmed their usefulness from a functional perspective, including concerning certain aspects that were represented as a “grey area”. Early risk prediction plays a key role in the subsequent management of patients, and to optimize risk prediction and intensity of management, one should take into account that: a) biomarkers have improved the understanding of the pathophysiology of heart failure and may therefore help to adjust the intensity of management in AHF; b) among the wide variety of biomarkers currently available, NT-proBNP and cTn seem the most promising in this indication; c) among the risk scores described, those combining demographic and clinical parameters with biomarkers in a model with routinely available rapid variables seem the most promising tools; d) in addition to biomarkers, age, systolic blood pressure, respiratory rate, oxygen saturation, creatinine, electrolytes, and blood urea nitrogen are the most commonly used predictor variables in the risk scores described; e) among the models selected, the MEESSI-AHF risk score appears to be currently the most promising tool for predicting the risk of AHF; f) during the management of decompensated patients (and in later stages), the psychological aspect is completely ignored, thus promoting the worsening of psychological symptoms (the need is as evident during the acute episode as it is in the daily management of chronic heart failure). Conclusions: The scientific literature search enriched the structure of ESC 2021, suggesting its implementation, with other findings related to new drug therapies such as Sotagliflozin, Hydrochlorothiazide Apabetalone, Alprostadil, Empagliflozin, Sacubitril/Valsartan, Dapagliflozin, Sodium-glucose co-transporter-2 inhibitors, and biomarkers such as Urinary sodium (UNa+), IL-6 levels and rh-brain natriuretic peptide (rhBNP), as well as the use of mindful breathing session, osteopathic manipulative treatment, electrical muscle stimulation, low-level tragus stimulation, venoarterial extracorporeal membrane oxygenation, oral nutritional supplements, and the correlative hypothesis between heart failure and intestinal dysbiosis, also concerning the psychological profile. However, these clinical studies suffer from some limitations that will necessarily have to be taken into account, such as the limited size of the population sample selected or the conflict of interest determined by the fact that some research is funded by the same pharmaceutical company producing the drug used that do not necessarily represent a negative limitation on the results obtained from studies.

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Effects of intravenous furosemide plus small‐volume hypertonic saline solutions on markers of heart failure

Cited by 11 publications

References 50 publications

Anti-Inflammatory Activities of Captopril and Diuretics on Macrophage Activity in Mouse Humoral Immune Response

Anti-Inflammatory Activities of Captopril and Diuretics on Macrophage Activity in Mouse Humoral Immune Response

Management of Hyponatremia in Heart Failure: Practical Considerations

Heart Failure (HF): Recent innovations in clinical therapy and critical profiles of acute and chronic forms

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