Intravenous torasemide for treatment of acute heart failure – practice in Zabrze. Case report Case report
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Published:
Sep 30, 2019
Keywords:
acute heart failure, congestion, treatment, loop diuretics, torasemide, furosemide
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Abstract
Heart failure is a complex clinical syndrome with dominating signs and symptoms coming from organ congestion. The use of diuretics is a fundamental treatment. In acute phase of heart failure usually loop diuretics given intravenously are applied. In Poland the furosemide and torasemide are most widely used to fight congestion. These drugs have a common mechanism of diuretic action but vary significantly in many other aspects. Their unique features are potentially clinically useful.
In patients with heart failure treated with diuretics excessive amount of fluid from interstitial compartment refills vascular space at a rate specific for heart failure phenotype. This hemodynamic characteristic called refilling rate plays critical role. When refilling rate falls behind diuretic rate relative hypovolemia may fallow leading to untoward consequences.
The paper presents clinical case in which the mismatch between diuresis induced by furosemide and refilling rate was likely reason for adverse events successfully resolved by replacement of furosemide to torasemide.
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How to Cite
Nowak, J., Buczkowska, M., Zbrojkiewicz , E., Mroczek , A., Gąsior, M., & Rozentryt, P. (2019). Intravenous torasemide for treatment of acute heart failure – practice in Zabrze. Case report. Medycyna Faktow (J EBM), 12(3(44), 186-195. https://doi.org/10.24292/01.MF.0319.1
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References
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12. Knauf H., Mutschler E., Velazquez H., Giebisch G.: Torasemide significantly reduces thiazide-induced potassium and magnesium loss despite supra-additive natriuresis. Eur. J. Clin. Pharmacol. 2009; 65(5): 465-472.
13. Boyle A., Sobotka P.A.: Redefining the Therapeutic Objective in Decompensated Heart Failure: Hemoconcentration as a Surrogate for Plasma Refill Rate. J. Card. Fail. 2006; 12(4): 247-249.
14. Miller W.L., Mullan B.P.: Understanding the Heterogeneity in Volume Overload and Fluid Distribution in Decompensated Heart Failure Is Key to Optimal Volume Management: Role for Blood Volume Quantitation. JACC Heart Fail. 2014; 2(3): 298-305.
15. Figueras J., Weil M.H.: Blood volume prior to and following treatment of acute cardiogenic pulmonary edema. Circulation 1978; 57(2): 349-355.
16. Miller W.L., Mullan B.P.: Volume Overload Profiles in Patients With Preserved and Reduced Ejection Fraction Chronic Heart Failure: Are There Differences? A Pilot Study. JACC Heart Fail. 2016; 4(6): 453-459.
17. Miller W.L., Mullan B.P.: Understanding the Heterogeneity in Volume Overload and Fluid Distribution in Decompensated Heart Failure Is Key to Optimal Volume Management Role for Blood Volume Quantitation. JACC Heart Fail. 2014; 2(3): 298-305.
18. Senthong V., Kirsop J.L., Tang W.H.W.: Clinical Phenotyping of Heart Failure with Biomarkers: Current and Future Perspectives. Curr. Heart Fail. Rep. 2017; 14(2): 106-116.
19. Shah S.J., Kitzman D.W., Borlaug B.A. et al.: Phenotype-Specific Treatment of Heart Failure With Preserved Ejection Fraction. Circulation 2016; 134(1): 73-90.
20. Hodson D.Z., Griffin M., Mahoney D. et al.: Natriuretic Response Is Highly Variable and Associated With 6-Month Survival: Insights From the ROSE-AHF Trial. JACC Heart Fail. 2019; 7(5): 383-391.
21. Girerd N., Seronde M.F., Coiro S. et al.: Integrative Assessment of Congestion in Heart Failure Throughout the Patient Journey. JACC Heart Fail. 2018; 6(4): 273-285.
22. Ng K.T., Yap J.L.L.: Continuous infusion vs. intermittent bolus injection of furosemide in acute decompensated heart failure: systematic review and meta-analysis of randomised controlled trials. Anaesthesia 2018; 73(2): 238-247.
23. Damman K., Kjekshus J., Wikstrand J. et al.: Loop diuretics, renal function and clinical outcome in patients with heart failure and reduced ejection fraction. Eur. J. Heart Fail. 2016; 18(3): 328-336.
24. Catlin J.R., Adams C.B., Louie D.J. et al.: Aggressive Versus Conservative Initial Diuretic Dosing in the Emergency Department for Acute Decompensated Heart Failure. Ann. Pharmacother. 2018; 52(1): 26-31.
25. Woodruff A.E., Kelley A.M., Hempel C.A. et al.: Discharge Diuretic Dose and 30-Day Readmission Rate in Acute Decompensated Heart Failure. Ann. Pharmacother. 2016; 50(6): 437-445.
26. Okabe T., Yakushiji T., Kido T. et al.: The association between high-dose loop diuretic use at discharge and cardiovascular mortality in patients with heart failure. ESC Heart Fail. 2017; 5(1): 87-94.
27. Parén P., Dahlström U., Edner M. et al.: Association of diuretic treatment at hospital discharge in patients with heart failure with all-cause shortand long-term mortality: A propensity score-matched analysis from SwedeHF. Int. J. Cardiol. 2018; 257: 118-124.
28. Testani J.M., Chen J., McCauley B.D. et al.: Potential Effects of Aggressive Decongestion During the Treatment of Decompensated Heart Failure on Renal Function and Survival. Circulation 2010; 122(3): 265-272.
29. Testani J.M., Brisco M.A., Chen J. et al.: Timing of hemoconcentration during treatment of acute decompensated heart failure and subsequent survival importance of sustained decongestion. J. Am. Coll. Cardiol. 2013; 62(6): 516-524.
30. Brisco M.A., Coca S.G., Chen J. et al.: Blood urea nitrogen/creatinine ratio identifies a high-risk but potentially reversible form of renal dysfunction in patients with decompensated heart failure. Circ. Heart Fail. 2013; 6(2): 233-239.
31. Koomans H.A., Geers A.B., Dorhout Mees E.J.: Plasma volume recovery after ultrafiltration in patients with chronic renal failure. Kidney Int. 1984; 26(6): 848-854.
32. Bilchick K.C., Chishinga N., Parker A.M. et al.: Plasma Volume and Renal Function Predict Six-Month Survival after Hospitalization for Acute Decompensated Heart Failure. Cardiorenal Med. 2018; 8(1): 61-70.
33. Shah S., Pitt B., Brater D.C. et al.: Sodium and Fluid Excretion With Torsemide in Healthy Subjects is Limited by the Short Duration of Diuretic Action. J. Am. Heart Assoc. 2017; 6(10): e006135.
34. Kasama S., Toyama T., Kurabayashi M.: Comparative effects of long and short-acting loop diuretics on mortality in patients with chronic heart failure. Int. J. Cardiol. 2017; 244: 242-244.
2. Sullivan M.J., Knight J.D., Higginbotham M.B., Cobb F.R.: Relation between central and peripheral hemodynamics during exercise in patients with chronic heart failure. Muscle blood flow is reduced with maintenance of arterial perfusion pressure. Circulation 1989; 80(4): 769-781.
3. Cooper L.B., Lippmann S.J., DiBello J.R. et al.: The Burden of Congestion in Patients Hospitalized With Acute Decompensated Heart Failure. Am. J. Cardiol. 2019 May 25. pii: S0002-9149(19)30597-1. DOI: 10.1016/j.amjcard.2019.05.030. [Epub ahead of print].
4. Yancy Clyde W., Jessup M., Bozkurt B. et al.: 2017 ACC/AHA/HFSA Focused Update of the 2013 ACCF/AHA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure Society of America. Circulation 2017; 136(6): e137-e161.
5. Domanski M., Norman J., Pitt B. et al.: Diuretic use, progressive heart failure, and death in patients in the studies of left ventricular dysfunction (SOLVD). J. Am. Coll. Cardiol. 2003; 42(4): 705-708.
6. Faris R.F., Flather M., Purcell H. et al.: Diuretics for heart failure. Cochrane Database of Syst. Rev. 2012 Feb 15; (2): CD003838. DOI: 10.1002/14651858.CD003838.pub3.
7. Mullens W., Damman K., Harjola V.P. et al.: The use of diuretics in heart failure with congestion – a position statement from the Heart Failure Association of the European Society of Cardiology. Eur. J. Heart Fail. 2019; 21(2): 137-155.
8. Islam M.S.: The Art and Science of Using Diuretics in the Treatment of Heart Failure in Diverse Clinical Settings. In: Islam MS, editor. Heart Failure: From Research to Clinical Practice: Volume 3. Cham: Springer International Publishing; 2018: 47-65.
9. Somasekharan S., Tanis J., Forbush B.: Loop diuretic and ion-binding residues revealed by scanning mutagenesis of transmembrane helix 3 (TM3) of Na-K-Cl cotransporter (NKCC1). J. Biol. Chem. 2012; 287(21): 17308-17317.
10. Oppermann M., Hansen P.B., Castrop H., Schnermann J.: Vasodilatation of afferent arterioles and paradoxical increase of renal vascular resistance by furosemide in mice. Am. J. Phys. Ren. Phys. 2007; 293(1): F279-F87.
11. Felker G.M., Mentz R.J.: Diuretics and Ultrafiltration in Acute Decompensated Heart Failure. J. Am. Coll. Cardiol. 2012; 59(24): 2145-2153.
12. Knauf H., Mutschler E., Velazquez H., Giebisch G.: Torasemide significantly reduces thiazide-induced potassium and magnesium loss despite supra-additive natriuresis. Eur. J. Clin. Pharmacol. 2009; 65(5): 465-472.
13. Boyle A., Sobotka P.A.: Redefining the Therapeutic Objective in Decompensated Heart Failure: Hemoconcentration as a Surrogate for Plasma Refill Rate. J. Card. Fail. 2006; 12(4): 247-249.
14. Miller W.L., Mullan B.P.: Understanding the Heterogeneity in Volume Overload and Fluid Distribution in Decompensated Heart Failure Is Key to Optimal Volume Management: Role for Blood Volume Quantitation. JACC Heart Fail. 2014; 2(3): 298-305.
15. Figueras J., Weil M.H.: Blood volume prior to and following treatment of acute cardiogenic pulmonary edema. Circulation 1978; 57(2): 349-355.
16. Miller W.L., Mullan B.P.: Volume Overload Profiles in Patients With Preserved and Reduced Ejection Fraction Chronic Heart Failure: Are There Differences? A Pilot Study. JACC Heart Fail. 2016; 4(6): 453-459.
17. Miller W.L., Mullan B.P.: Understanding the Heterogeneity in Volume Overload and Fluid Distribution in Decompensated Heart Failure Is Key to Optimal Volume Management Role for Blood Volume Quantitation. JACC Heart Fail. 2014; 2(3): 298-305.
18. Senthong V., Kirsop J.L., Tang W.H.W.: Clinical Phenotyping of Heart Failure with Biomarkers: Current and Future Perspectives. Curr. Heart Fail. Rep. 2017; 14(2): 106-116.
19. Shah S.J., Kitzman D.W., Borlaug B.A. et al.: Phenotype-Specific Treatment of Heart Failure With Preserved Ejection Fraction. Circulation 2016; 134(1): 73-90.
20. Hodson D.Z., Griffin M., Mahoney D. et al.: Natriuretic Response Is Highly Variable and Associated With 6-Month Survival: Insights From the ROSE-AHF Trial. JACC Heart Fail. 2019; 7(5): 383-391.
21. Girerd N., Seronde M.F., Coiro S. et al.: Integrative Assessment of Congestion in Heart Failure Throughout the Patient Journey. JACC Heart Fail. 2018; 6(4): 273-285.
22. Ng K.T., Yap J.L.L.: Continuous infusion vs. intermittent bolus injection of furosemide in acute decompensated heart failure: systematic review and meta-analysis of randomised controlled trials. Anaesthesia 2018; 73(2): 238-247.
23. Damman K., Kjekshus J., Wikstrand J. et al.: Loop diuretics, renal function and clinical outcome in patients with heart failure and reduced ejection fraction. Eur. J. Heart Fail. 2016; 18(3): 328-336.
24. Catlin J.R., Adams C.B., Louie D.J. et al.: Aggressive Versus Conservative Initial Diuretic Dosing in the Emergency Department for Acute Decompensated Heart Failure. Ann. Pharmacother. 2018; 52(1): 26-31.
25. Woodruff A.E., Kelley A.M., Hempel C.A. et al.: Discharge Diuretic Dose and 30-Day Readmission Rate in Acute Decompensated Heart Failure. Ann. Pharmacother. 2016; 50(6): 437-445.
26. Okabe T., Yakushiji T., Kido T. et al.: The association between high-dose loop diuretic use at discharge and cardiovascular mortality in patients with heart failure. ESC Heart Fail. 2017; 5(1): 87-94.
27. Parén P., Dahlström U., Edner M. et al.: Association of diuretic treatment at hospital discharge in patients with heart failure with all-cause shortand long-term mortality: A propensity score-matched analysis from SwedeHF. Int. J. Cardiol. 2018; 257: 118-124.
28. Testani J.M., Chen J., McCauley B.D. et al.: Potential Effects of Aggressive Decongestion During the Treatment of Decompensated Heart Failure on Renal Function and Survival. Circulation 2010; 122(3): 265-272.
29. Testani J.M., Brisco M.A., Chen J. et al.: Timing of hemoconcentration during treatment of acute decompensated heart failure and subsequent survival importance of sustained decongestion. J. Am. Coll. Cardiol. 2013; 62(6): 516-524.
30. Brisco M.A., Coca S.G., Chen J. et al.: Blood urea nitrogen/creatinine ratio identifies a high-risk but potentially reversible form of renal dysfunction in patients with decompensated heart failure. Circ. Heart Fail. 2013; 6(2): 233-239.
31. Koomans H.A., Geers A.B., Dorhout Mees E.J.: Plasma volume recovery after ultrafiltration in patients with chronic renal failure. Kidney Int. 1984; 26(6): 848-854.
32. Bilchick K.C., Chishinga N., Parker A.M. et al.: Plasma Volume and Renal Function Predict Six-Month Survival after Hospitalization for Acute Decompensated Heart Failure. Cardiorenal Med. 2018; 8(1): 61-70.
33. Shah S., Pitt B., Brater D.C. et al.: Sodium and Fluid Excretion With Torsemide in Healthy Subjects is Limited by the Short Duration of Diuretic Action. J. Am. Heart Assoc. 2017; 6(10): e006135.
34. Kasama S., Toyama T., Kurabayashi M.: Comparative effects of long and short-acting loop diuretics on mortality in patients with chronic heart failure. Int. J. Cardiol. 2017; 244: 242-244.