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Summary
Background
Loop diuretics have two different classes with different duration of activity: short-acting such as furose
mide (duration of activity, 6 h) and long-acting such as azose
mide (duration of activity, 10-12 h). We conducted a
multicenter, rando
mized, controlled trial in order to co
mpare the therapeutic effects of azose
mide, a long-acting loop diuretic, and furose
mide, a short-acting one, on neurohu
moral factors and cardiac function in outpatients with chronic heart failure (CHF).
Methods
We enrolled 98 patients with CHF who were receiving furosemide and an angiotensin-converting enzyme inhibitor, and they were randomly divided into furosemide (m>nm> = 49) and azosemide (m>nm> = 49) groups. The furosemide group continued furosemide at the same dosage, and the azosemide group switched from furosemide to azosemide. At baseline and after 3 months, we measured body weight, and levels of brain natriuretic peptide (BNP), atrial natriuretic peptide (ANP), norepinephrine, active renin, creatinine, blood urea nitrogen, sodium, potassium, and hematocrit. Chest X-ray and echocardiography were also performed.
Results
Body weight and plasma levels of BNP and ANP significantly decreased after 3 months in the azosemide group compared to the furosemide group. There were no significant differences in changes of levels of creatinine, blood urea nitrogen, sodium, potassium, hematocrit, norepinephrine, and active renin after 3 months between the furosemide and azosemide groups. Echocardiography and chest X-ray did not demonstrate significant differences between the two groups.
Conclusions
Long-acting azosemide is suggested to be useful for the improvement of neurohumoral factors compared with short-acting furosemide in patients with CHF.