Comparison of the clinical efficacy of loop diuretics in the treatment of chronic heart failure.
Gorbunova M. L., Vlasova T. V.

Nizhny Novgorod State Medical Academy

Introduction. The article discusses the features of the diuretics action mechanism. There is a comparative analysis of diuretics depending on the action point, as well as a comparison of the pharmacological properties of drugs of the same class (loop diuretics - furosemide and torasemide). The authors conducted monitoring of patients with chronic heart failure (CHF).
Aim. Evaluation of the effectiveness and safety of torasemide (Lotonel, «Vertex») for the patients with CHF.
Patients and methods. 48 patients with heart failure were randomized into 2 groups: 20 patients received torasemide (Lotonel, «Vertex») in addition to the basic therapy for 3 months, and 18 patients received furosemide. Patients included in the study had clinical signs of  heart failure of II-III stage. Examination of patients included determination of FC of CHF according to NYHA, severity of the clinical condition, using a rating scale of clinical state (RSCS), the registered ECG in 12 leads, EchoCG, blood sampling to determine electrolyte metabolism and creatinine, as well as a 6-minute walk test.
Results and conclusion: at baseline and after 3 months of therapy all the patients were examined  for their clinical condition, hemodynamic status, quality of life and functional status of the left ventricle (LV), the levels of electrolyte metabolism and creatinine were also determined. The effects of both diuretics on body weight, edema, shortness of breath were comparable. After 3 months in both groups the results of EchoCG showed an improved decrease in the end-diastolic volume (EDV), as well as a significant increase in LVEF. There was a significant increase in the distance of a 6-min walk test in the torasemide group, torasemide had less influence on the potassium excretion. The results confirmed the safety and efficacy of the use of torasemid and furosemide in the assessment of the clinical condition severity and improvement of the quality of life of the patients with moderate compensated CHF. However, clinical and hemodynamic characteristics of torasemid were superior to furosemide.

Key words: chronic heart failure, loop diuretics, torasemid, furosemide.
For citation: Gorbunova M. L., Vlasova T. V. Comparison of the clinical efficacy of loop diuretics in the treatment of chronic heart failure // RMJ. 2017. № 4. P. 252–256.