Open AccessInfluence of cardiac function on the diuretic and hemodynamic effects of the loop diuretic piretanide
Author(s) -
Hasenfuss G.,
Holubarsch C.,
Herzog C.,
Knauf H.,
Just H.,
Spahn H.,
Mutschler E.
Publication year - 1987
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.4960100203
Subject(s) - diuretic , medicine , diuresis , renal sodium reabsorption , loop diuretic , hemodynamics , pulmonary wedge pressure , heart failure , natriuresis , reabsorption , blood pressure , endocrinology , renal function , cardiology , pharmacology , kidney
The influence of caridac function on the diuretic and hemodynamic effects of the loop diuretic piretanide was investigated in nine patients with congestive heart failure. The diuretic response to piretanide correlated significantly with the pretreatment cardiac index (r=0.90). Furthermore, a significant correlation was found between the pretreatment fractional sodium excretion and the cardiac index (r=0.85). The fractional sodium excretion is reciprocal to the renal sodium and water reabsorption. No change in the hemodynamics was observed prior to the onset of diuresis. At 120 minutes after administration of piretanide, the reduction of mean pulmonary capillary wedge pressure (r=0.88) and mean right atrial pressure (r=0.80) was significantly related to the diuretic response. We conclude that the reduced diuretic response to piretanide in patients with low cardiac index is due to increased renal sodium and water reabsorption. The hemodynamic changes following the administration of piretanide are dependent on the diuresis.