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Efficacy and safety of torasemide in children with heart failure.

Abstract：

OBJECTIVE:To examine the efficacy and safety of torasemide in children with chronic heart failure (HF). METHODS:102 children with chronic HF who had received oral torasemide were analysed. Of these, 62 (de novo group) were newly diagnosed as having HF and were given torasemide as a diuretic. The remaining 40 (replacement group) had been given furosemide for >3 months before the study, and furosemide was then replaced with torasemide. Clinical signs and symptoms of HF (assessed as the HF index), humoral factors and serum potassium concentrations before torasemide treatment were compared with those obtained 3-4 weeks after torasemide treatment. Patients were also monitored for adverse effects. RESULTS:In the de novo group, torasemide significantly improved the HF index with concomitant improvement in plasma brain natriuretic peptide concentration (median (interquartile range) 52 (51) vs 43 (49) pg/ml). In a randomly selected group of 25 de novo patients with ventricular septal defect, echocardiography showed that torasemide significantly improved left ventricular geometry and function. In the replacement group, brain natriuretic peptide concentrations were also significantly decreased from 50 (104) to 45 (71) pg/ml after substitution of torasemide, but the HF index showed only a tendency for improvement (p = 0.07). Torasemide also had a potassium-sparing effect (de novo group, no change in potassium concentration; replacement group, significant increase from 4.2 (0.5) to 4.3 (0.5) mEq/l), and caused a significant rise in serum aldosterone concentration, consistent with the anti-aldosterone effect of this drug. Serum concentrations of sodium and uric acid had not changed after torasemide treatment, and there were no serious adverse events that necessitated drug withdrawal. CONCLUSION:Torasemide can be safely used, and appears to be effective for treatment of HF in children. Future clinical trials are warranted to verify the present results.

journal_name

Arch Dis Child

journal_title

Archives of disease in childhood

authors

Senzaki H,Kamiyama M,Masutani S,Ishido H,Taketazu M,Kobayashi T,Katogi T,Kyo S

doi

10.1136/adc.2007.129239

subject

Has Abstract

pub_date

2008-09-01 00:00:00

pages

768-71

issue

eissn

0003-9888

issn

1468-2044

pii

adc.2007.129239

journal_volume

pub_type

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Efficacy and safety of torasemide in children with heart failure.