Cardiovascular Drugs and Therapy

, Volume 4, Issue 2, pp 515–521 | Cite as

Acute and chronic effects of a diuretic monotherapy with piretanide in congestive heart failure—A placebo-controlled trial

  • W. Haerer
  • U. Bauer
  • N. Sultan
  • K. Cernoch
  • N. Mouselimis
  • K. J. Fehske
  • M. Hetzel
  • M. Stauch
  • V. Hombach
Congestive Heart Failure

Summary

To evaluate the acute and chronic effects of diuretic monotherapy with 3 mg piretanide bid, 46 patients (pts) with congestive heart failure (NYHA II-III) secondary to coronary artery disease were studied. Within 3 weeks of therapy, the patients lost 1.6 kg body weight. Forty-four patients reported a subjective feeling of improvement. Echocardiographically, a highly significant (p<0.001) reduction of diastolic and systolic diameters was found, as well as an increase of fraction shortening. Chest x-ray indicated a reduction of heart volume from 1012±263 ml to 936±233 ml (p<0.001). The serum potassium level remained unchanged. A subgroup of 26 pts underwent invasive hemodynamic examinations. IV injection of 6 mg piretanide resulted in an acute reduction of pulmonary wedge pressure (pc) from 20.2±5.3 mmHg to 11.9±5.0 mmHg (p<0.001); simultaneously a slight decrease of cardiac index from 3.2±0.6 l/min/m2 to 3.0±0.4 l/min/m2 was observed. Invasive control after 3 weeks of oral therapy showed no decline of the piretanide effect. The exercise tolerance increased clearly from 135±161 Wmin to 249±268 Wmin (p<0.05). A control group of further 14 pts was treated with placebo only and did not show any significant changes of pc (20.0±6.4 mmHg vs. 22.8±19.2 mmHg), exercise tolerance, or other clinical parameters. Thus, the diuretic monotherapy of congestive heart failure with piretanide is highly effective and shows a significant improvement in all clinical and hemodynamic parameters in the absence of any remarkable side effects.

Key Words

congestive heart failure diuretic monotherapy hemodynamics piretanide placebo 

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Copyright information

© Kluwer Academic Publishers 1990

Authors and Affiliations

  • W. Haerer
    • 2
  • U. Bauer
    • 1
  • N. Sultan
    • 1
  • K. Cernoch
    • 1
  • N. Mouselimis
    • 1
  • K. J. Fehske
    • 2
  • M. Hetzel
    • 2
  • M. Stauch
    • 2
  • V. Hombach
    • 2
  1. 1.Center of Cardiovascular DiseasesRotenburg a.d. FuldaFRG
  2. 2.Cardiology DepartmentUniversity of UlmUlmFRG

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