Furosemide and the progression of left ventricular dysfunction in experimental heart failure

McCurley, John M.; Hanlon, Stephen U.; Wei, Shao-kui; Wedam, Erich F.; Michalski, M. F. P.; Haigney, Mark C.

doi:10.1016/j.jacc.2004.04.059

Cited by 135 publications

(108 citation statements)

References 33 publications

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“…23) Furosemide increased the urinary volume because of its potent natriuretic action, but increases in sCr, decreases in eGFR, exacerbation of the RAAS and conversely, aggravated renal dysfunction has also been reported. 20,23,27,28) In the present research, strong natriuresis was observed in the placebo group. The reason for this appeared to be that many patients in the placebo group used furosemide.…”

Section: Discussionsupporting

confidence: 52%

Early Results of Human Atrial Natriuretic Peptide Infusion in Non-Dialysis Patients with Chronic Kidney Disease Undergoing Isolated Coronary Artery Bypass Grafting: the NU-HIT Trial for CKD-II

Sezai

Nakata

Iida

et al. 2014

ATCS

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Background: Chronic kidney disease (CKD) is an important risk factor for cardiac surgery. In the most recently reported NU-HIT trial for CKD with CKD patients underwent coronary artery bypass grafting (CABG) as subjects, carperitide was reported to be effective in terms of renal function. In the present study, a subanalysis was performed on patients registered in the NU-HIT trial for CKD from the standpoint of renin-angiotensin system, natriuresis and renal function. Methods: 303 patients with CKD who underwent isolated CABG were divided into a group that received carperitide infusion and another group without carperitide. The renin activity, angiotensin-II, aldosterone, urine-sodium, urine-creatinine, fractional sodium excretion, renal failure index, and BNP levels. Results: There were significant lower in hANP group than the placebo group, in angiotensin-II at one day postoperatively, and in aldosterone from 0 day to one month postoperatively. FENa was significantly lower in the hANP group at 3 day and one week postoperatively. Conclusions: In on pump isolated CABG patients with CKD, carperitide showed a potent natriuretic action and inhibited the renin-angiotensin system, suggesting that it prevented deterioration of postoperative renal function. Our findings raise new possibilities for the perioperative and postoperative management of patients undergoing surgery with cardiopulmonary bypass.

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Section: Discussionsupporting

confidence: 52%

Early Results of Human Atrial Natriuretic Peptide Infusion in Non-Dialysis Patients with Chronic Kidney Disease Undergoing Isolated Coronary Artery Bypass Grafting: the NU-HIT Trial for CKD-II

Sezai

Nakata

Iida

et al. 2014

ATCS

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“…Our results may provide basic information related to urine output and natriuresis as models of short-and longacting loop diuretics. Loop diuretic administration is associated with activation of neurohumoral axes such as the plasma concentrations of aldosterone, renin and norepinephrine [14,24,27,32]. However, the response of the RAA system to furosemide differs with diuretic duration.…”

Section: Discussionmentioning

confidence: 99%

Differences in the Duration of Diuretic Effects and Impact on the Renin-Angiotensin-Aldosterone System of Furosemide in Healthy Dogs

Hori

Ohshima

Kanai

et al. 2010

The Journal of Veterinary Medical Science

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ABSTRACT. Our aim was to investigate the differences in the duration of diuretic effects and impact on the renin-angiotensin-aldosterone (RAA) system of furosemide as a model of short-and long-acting loop diuretics. Anesthetized dogs (n=6) were randomized into placebo, intravenous bolus administration (IB) and chronic rate infusion (CRI) groups. This study was conducted with a crossover study. Furosemide (4 mg/kg) was diluted to 18 mL in sterile saline. Furosemide was infused at 0.5 mg/kg/hr for 8 hr in the CRI group or was injected at 0 and 4 hr (both 2 mg/kg) in the IB group. Blood and urine samples were collected at baseline and at 1, 2, 4, 5, 6 and 8 hr. Compared with the baseline, the IB group had a significantly increased urine output at 1 and 5 hr. The CRI group had a significantly increased urine output persisting for 4 hr compared with the baseline. Compared with the placebo group, 8-hr urine output and 8-hr sodium excretion were significantly increased in the IB and CRI groups; the values in the CRI group were significantly higher than those in the IB group. Eight-hour potassium excretion was significantly increased in the IB and CRI groups. The plasma aldosterone concentration was significantly elevated in the IB group at 8 hr. Duration of action may be a predominant cause of loop diuretic-related differences. Persistent diuresis may cause greater diuretic effects than transient diuresis, with less elevation of the plasma aldosterone concentration.KEY WORDS: canine, diuretic resistance, loop diuretics, plasma aldosterone concentrations.J. Vet. Med. Sci. 72(1): 13-18, 2010 Loop diuretics are recommended as a first-line therapy in the management of congestive heart failure (CHF) and are important in the symptomatic treatment [19]. They can be divided into short-acting ones, such as furosemide, and long-acting ones, such as azosemide and torasemide. Although furosemide is commonly used in clinical settings, its main complication is that patients with CHF develop resistance to loop diuretics due to a reduction in the glomerular filtration rate and an increase in sodium reabsorption at diuretic-insensitive sites in the nephron [6,10,11,28]. Additionally, furosemide activates the renin-angiotensinaldosterone (RAA) system and the sympathetic nervous system [14,16,32].In contrast to furosemide, previous studies have revealed that long-acting loop diuretics have clinical efficacy; they cause less activation of the RAA system, reduce diuretic resistance, improve ventricular fibrosis and decrease the mortality rate in both humans and animal models [7,17,23,37]. Furosemide treatment for 14 days leads to diuretic resistance in dogs, but this does not occur with torasemide [17]. In human clinical study, the myocardial collagen volume decreases with torasemide, but remains unchanged with furosemide [23]. Additionally, a recent study showed that torasemide is associated with lower mortality compared with furosemide in patients with CHF [7]. Similarly, our previous data suggested that azosemide causes mild and long...

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“…Furosemide activates the RAAS and SNS, 4,5 accelerates LV dysfunction and elevates serum aldosterone. 24 In contrast, partial RAAS blockade could activate one or more RAAS components with resultant activation of angiotensin or aldosterone receptor, which is known as breakthrough phenomenon. 26 Thus, combination use of RAAS inhibitors and β-blockers with loop diuretics is important to improve prognosis in HF patients with low-dose loop diuretics.…”

Section: Combination Of Raas Inhibitors And/or β-Blockers With Loop Dmentioning

confidence: 99%

Prognostic Impact of Loop Diuretics in Patients With Chronic Heart Failure　– Effects of Addition of Renin-Angiotensin-Aldosterone System Inhibitors and β-Blockers –

Miura

Sugimura

Sakata

et al. 2016

Circ J

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on behalf of the CHART-2 InvestigatorsBackground: It remains to be elucidated whether addition of renin-angiotensin-aldosterone system (RAAS) inhibitors and/or β-blockers to loop diuretics has a beneficial prognostic impact on chronic heart failure (CHF) patients. Methods and Results:From the Chronic Heart failure Analysis and Registry in the Tohoku district 2 (CHART-2) Study (n=10,219), we enrolled 4,134 consecutive patients with symptomatic stage C/D CHF (mean age, 69.3 years, 67.7% male). We constructed Cox models for composite of death, myocardial infarction, stroke and HF admission. On multivariate inverse probability of treatment weighted (IPTW) Cox modeling, loop diuretics use was associated with worse prognosis with hazard ratio (HR) 1.28 (P<0001). Furthermore, on IPTW multivariate Cox modeling for multiple treatments, both low-dose (<40 mg/day) and high-dose (≥40 mg/day) loop diuretics were associated with worse prognosis with HR 1.32 and 1.56, respectively (both P<0.001). Triple blockade with RAS inhibitor(s), mineral corticoid (aldosterone) receptor antagonist(s) (MRA), and β-blocker(s) was significantly associated with better prognosis in those on low-dose but not on high-dose loop diuretics. Conclusions:Chronic use of loop diuretics is significantly associated with worse prognosis in CHF patients in a dose-dependent manner, whereas the triple combination of RAAS inhibitor(s), MRA, and β-blocker(s) is associated with better prognosis when combined with low-dose loop diuretics. (Circ J 2016; 80: 1396 -1403

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Furosemide and the progression of left ventricular dysfunction in experimental heart failure

Abstract: Tachycardic pigs given furosemide had significant acceleration of both contractile and metabolic features of CHF, including left ventricular systolic dysfunction, elevated serum aldosterone levels, and altered calcium handling in a controlled experimental model of heart failure.

Cited by 135 publications

References 33 publications

Early Results of Human Atrial Natriuretic Peptide Infusion in Non-Dialysis Patients with Chronic Kidney Disease Undergoing Isolated Coronary Artery Bypass Grafting: the NU-HIT Trial for CKD-II

Early Results of Human Atrial Natriuretic Peptide Infusion in Non-Dialysis Patients with Chronic Kidney Disease Undergoing Isolated Coronary Artery Bypass Grafting: the NU-HIT Trial for CKD-II

Differences in the Duration of Diuretic Effects and Impact on the Renin-Angiotensin-Aldosterone System of Furosemide in Healthy Dogs

Prognostic Impact of Loop Diuretics in Patients With Chronic Heart Failure　– Effects of Addition of Renin-Angiotensin-Aldosterone System Inhibitors and β-Blockers –

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Furosemide and the progression of left ventricular dysfunction in experimental heart failure

Abstract: Tachycardic pigs given furosemide had significant acceleration of both contractile and metabolic features of CHF, including left ventricular systolic dysfunction, elevated serum aldosterone levels, and altered calcium handling in a controlled experimental model of heart failure.

Cited by 135 publications

References 33 publications

Early Results of Human Atrial Natriuretic Peptide Infusion in Non-Dialysis Patients with Chronic Kidney Disease Undergoing Isolated Coronary Artery Bypass Grafting: the NU-HIT Trial for CKD-II

Early Results of Human Atrial Natriuretic Peptide Infusion in Non-Dialysis Patients with Chronic Kidney Disease Undergoing Isolated Coronary Artery Bypass Grafting: the NU-HIT Trial for CKD-II

Differences in the Duration of Diuretic Effects and Impact on the Renin-Angiotensin-Aldosterone System of Furosemide in Healthy Dogs

Prognostic Impact of Loop Diuretics in Patients With Chronic Heart Failure – Effects of Addition of Renin-Angiotensin-Aldosterone System Inhibitors and β-Blockers –

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Prognostic Impact of Loop Diuretics in Patients With Chronic Heart Failure　– Effects of Addition of Renin-Angiotensin-Aldosterone System Inhibitors and β-Blockers –