Emerging Role of Low-dose Loop Diuretics in the Management of Heart Failure Patients to Maintain Euvolemia.

Pravesh Vishwakarma, Rajiv Passey, Nitin Zalte, Amarnath Sugumaran, Sandeep Sharma, Aditya Kapoor, Bhupen Desai, Debdatta Bhattacharya, Jai Kumar Agarwal, Gajjala Mahesh Reddy, Aniruddha Balkrishna Chandorkar, Rajeev Marwaha, Ramraj Guruswami

Journal: The Journal of the Association of Physicians of India 2024;72(9S):24-26

PMID: 39291569

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Abstract

The current scenario of employing loop diuretics in combination with guideline-directed medical therapy (GDMT) demonstrates a comprehensive approach to improving clinical outcomes in individuals with heart failure (HF). GDMT uses four types of drugs: angiotensin receptor-neprilysin inhibitors (ARNIs), beta-blockers (BBs), mineralocorticoid receptor antagonists (MRAs), and sodium-glucose cotransporter-2 inhibitors (SGLT2i). Torsemide, furosemide, and bumetanide are common loop diuretics used to control fluid overload in HF and provide symptomatic relief. Furthermore, loop diuretics are frequently used in advanced and decompensated HF. The combination of GDMT and loop diuretics is designed to improve quality of life, reduce hospitalization rates, and increase survival. Guidelines suggest the use of low-dose loop diuretics in patients with HF who have a previous history of congestion to maintain euvolemia. According to recent studies and guidelines, individualized regimens for the use of GDMT and loop diuretics are required to optimize therapeutic efficacy in terms of clinical status, fluid retention, electrolyte balance, and renal function.

Address: Senior Cardiologist and Chief Intervention Cardiologist, Department of Cardiology, Jeevan Jyoti Heart Institute, Agra, Uttar Pradesh, India, Corresponding Author.; Consultant Interventional Cardiologist, Department of Cardiology, Sai Mahesh Cardiac and Maternity Care, Tirupati, Andhra Pradesh, India.; Professor and Head, Department of Cardiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.; Senior Interventional Cardiologist, Department of Cardiology, Rabindranath Tagore International Institute of Cardiac Sciences, Kolkata, West Bengal, India.; Consultant Interventional Cardiologist, Department of Cardiology, Ruby Hall Clinic, Pune, Maharashtra, India.; Senior Consultant Cardiologist and Head, Department of Cardiology, Karuna Hospital, Mumbai, Maharashtra, India.; Interventional Cardiologist, Department of Cardiology, Super Speciality Hospital, Jammu, Jammu and Kashmir, India.; Associate Professor, Department of Cardiology, Indira Gandhi Medical College and Hospital, Shimla, Himachal Pradesh, India.; Senior Consultant Interventional Cardiologist, Department of Cardiology, Sir Ganga Ram Hospital, Delhi, India.; Additional Professor, Department of Cardiology, King George's Medical University, Lucknow, Uttar Pradesh, India.; Senior Consultant Cardiologist, Department of Cardiology, Royal Care Hospital City Unit, Coimbatore, Tamil Nadu, India.; Senior Team Lead, Medical Affairs, Cipla Ltd., Mumbai, Maharashtra, India.; Cluster Medical Head, Medical Affairs, Cipla Ltd., Mumbai, Maharashtra, India.

DOI: 10.59556/japi.72.0673

Link outs

Free resources

Medical:

https://medlineplus.gov/heartfailure.html

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https://assays.cancer.gov/non-CPTAC-2658

Research Materials:

https://antibodies.cancer.gov/detail/CPTC-GZMA-1

MeSH Terms: Humans, Heart Failure, Sodium Potassium Chloride Symporter Inhibitors