Optimization of the treatment of edema syndrome in patients with chronic heart failure
A.G. Yevdokimova, E.V. Kovalenko, V.V. Yevdokimov, I.M. Mikhailova

A.I. Yevdokimov Moscow State University of Medicine and Dentistry

The article considers the mechanisms of the fluid retention syndrome in patients with chronic heart failure (CHF). The classification of diuretics is given depending on the points of application of their action in the nephron. Particular attention is paid to the negative role of hyperaldosteronism in CHF and the possibility of its control when using torasemide and eplerenone. Based on numerous, multicenter clinical studies, the advantage of using a loop diuretic with an antialdosterone effect — torasemide and an antagonist of mineral corticoid receptors — eplerenone in the complex therapy of CHF is shown. It is emphasized that after intaking the initial dose of torasemide, diuretic and antihypertensive effects appear immediately, and the antifibrotic effect requires a certain time, which is due to a change in collagen occurring during 6-9 months of continuous drug therapy. In connection with this, it is necessary to take into account the long-term, sometimes lifelong, use of torasemide in the management of patients with CHF, arterial hypertension and defeat of target organs. The article presents data, within the framework of evidence-based medicine, on the high clinical efficacy of eplerenone in patients with CHF and a reduced ejection fraction with or without myocardial infarction. Thus, the use of torasemide and eplerenone helps not only to improve the quality of life of serious patients, but also the prognosis.

Key words: chronic heart failure, edema syndrome, torasemide, Trigrim, eplerenone, Espiro.
For citation: Yevdokimova A.G., Kovalenko E.V., Yevdokimov V.V., Mikhailova I.M. Optimization of the treatment of edema syndrome in patients with chronic heart failure // RMJ. 2018. № 11(I). P. 47–53.