Clinical inquiries. Does furosemide decrease morbidity or mortality for patients with diastolic or systolic dysfunction?

Abstract

No large-scale randomized, placebo-controlled trials evaluate furosemide's effect on mortality and long-term morbidity in diastolic or systolic dysfunction. In short-term studies, furosemide reduces edema, reduces hospitalizations, and improves exercise capacity in the setting of systolic dysfunction (strength of recommendation [SOR]: B, based upon low-quality randomized controlled trials). Furosemide and other diuretics reduce symptomatic volume overload in diastolic and systolic dysfunction (SOR: C, based on expert opinion). There is potential morbidity with the use of high-dose loop diuretics (volume contraction, electrolyte disturbances, and neuroendocrine activation). Use of high-dose loop diuretics for systolic dysfunction is associated with increased mortality, sudden death, and pump failure death (SOR: B, based on retrospective analyses of large-scale randomized controlled trials). However, diuretic resistance or disease severity may explain these latter findings.

• Authors: Amrit Singh, Jean Blackwell, Jon Neher
• Journal: The Journal of family practice (J Fam Pract) Vol. 54 Issue 4 Pg. 370-2 (Apr 2005) ISSN: 0094-3509 [Print] United States
• PMID: 15833232 (Publication Type: Journal Article, Review)

Chemical References

• Diuretics
• Furosemide

Topics

• Diuretics (therapeutic use)
• Exercise Tolerance (drug effects)
• Furosemide (therapeutic use)
• Heart Failure (complications, mortality, prevention & control)
• Humans
• Patient Readmission
• Treatment Outcome