PT  - JOURNAL ARTICLE
AU  - Yae Matsuo
AU  - Shu Kasama
AU  - Takuji Toyama
AU  - Ryuichi Funada
AU  - Noriaki Takama
AU  - Norimichi Koitabashi
AU  - Shuichi Ichikawa
AU  - Yasuyuki Suzuki
AU  - Naoya Matsumoto
AU  - Yuichi Sato
AU  - Masahiko Kurabayashi
TI  - Comparative effects of long-acting and short-acting loop diuretics on cardiac sympathetic nerve activity in patients with chronic heart failure
AID  - 10.1136/openhrt-2015-000276
DP  - 2016 Feb 01
TA  - Open Heart
PG  - e000276
VI  - 3
IP  - 1
4099  - http://openheart.bmj.com/content/3/1/e000276.short
4100  - http://openheart.bmj.com/content/3/1/e000276.full
SO  - Open Heart2016 Feb 01; 3
AB  - Objective Short-acting loop diuretics are known to enhance cardiac sympathetic nerve activity (CSNA) in patients with chronic heart failure (CHF). The effects of two loop diuretics—long-acting azosemide and short-acting furosemide—on CSNA were evaluated using 123I-metaiodobenzylguanidine (MIBG) scintigraphy in patients with CHF.Methods The present study was a subanalysis of our previously published study, which had reported that serial 123I-MIBG studies were the most useful prognostic indicator in patients with CHF. Patients with CHF (n=208, left ventricular ejection fraction <45%) but no history of cardiac events for at least 5 months prior to the study were identified according to their histories of acute decompensated heart failure requiring hospitalisation. Patients underwent 123I-MIBG scintigraphy immediately before hospital discharge and at a 6-month follow-up. The delayed % denervation, delayed heart/mediastinum count (H/M) ratio and washout rate (WR) were determined using 123I-MIBG scintigraphy. A total of 108 patients were selected, and propensity score matching was used to compare patients treated with either oral azosemide (n=54) or furosemide (n=54).Results After treatment, 123I-MIBG scintigraphic parameters improved in both groups. However, the degree of change in % denervation was −13.8±10.5 in the azosemide group and −5.7±12.7 in the furosemide group (p<0.01), the change in H/M ratio was 0.20±0.16 in the azosemide group and 0.06±0.19 in the furosemide group (p<0.01), and the change in WR was −11.3±9.2% in the azosemide group and −3.0±12.7% in the furosemide group (p<0.01). Moreover, multivariate analysis showed an independent and significant positive relationship between furosemide and δ-WR from hospital discharge to 6 months after treatment in patients with CHF (p=0.001).Conclusions These findings indicate that azosemide suppresses CSNA compared with furosemide in patients with CHF.Trial registration number UMIN000000626 (UMIN-CTR Clinical Trial).