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

Cardiovascular Drugs and Therapy volume 4, pages 515–521 (1990)Cite this article

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.

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Affiliations

  1. Center of Cardiovascular Diseases, Rotenburg a.d. Fulda, FRG

    U. Bauer, N. Sultan, K. Cernoch & N. Mouselimis

  2. Cardiology Department, University of Ulm, Robert-Koch-Str. 8, D-7900, Ulm, FRG

    W. Haerer M. D., K. J. Fehske, M. Hetzel, M. Stauch & V. Hombach

Authors
  1. W. Haerer M. D.
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  2. U. Bauer
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  3. N. Sultan
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  4. K. Cernoch
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  5. N. Mouselimis
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  6. K. J. Fehske
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  7. M. Hetzel
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  8. M. Stauch
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  9. V. Hombach
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Haerer, W., Bauer, U., Sultan, N. et al. Acute and chronic effects of a diuretic monotherapy with piretanide in congestive heart failure—A placebo-controlled trial. Cardiovasc Drug Ther 4, 515–521 (1990). https://doi.org/10.1007/BF01857763

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  • DOI: https://doi.org/10.1007/BF01857763

Key Words

  • congestive heart failure
  • diuretic monotherapy
  • hemodynamics
  • piretanide
  • placebo