The Experts below are selected from a list of 201 Experts worldwide ranked by ideXlab platform
Satoshi Nakatani - One of the best experts on this subject based on the ideXlab platform.
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Changes in brain natriuretic peptide in chronic heart failure patients treated with long-acting versus short-acting loop diuretics: J-MELODIC subanalysis
Heart and Vessels, 2017Co-Authors: Miho Fukui, Takeshi Tsujino, Shinichi Hirotani, Hiroshi Ito, Kazuhiro Yamamoto, Takashi Akasaka, Yutaka Hirano, Nobuyuki Ohte, Takashi Daimon, Satoshi NakataniAbstract:We have previously reported that a long-acting loop diuretic, Azosemide, reduces cardiovascular risks in patients with chronic heart failure (CHF) as compared with a short-acting one, furosemide, in Japanese Multicenter Evaluation of LOng- versus short-acting Diuretics In Congestive heart failure (J-MELODIC). However, the mechanisms of the difference have not been elucidated. This study aimed to examine whether there is a difference in the reduction in plasma brain natriuretic peptide (BNP) level and in left ventricular (LV) functional recovery between the CHF patients treated with the long-acting diuretic (the Azosemide group) and the short-acting diuretic (the furosemide group). We reviewed changes in plasma BNP level and echo-assessed LV functional parameters from baseline to a year after the entry in 288 CHF patients with New York Heart Association class II or III symptoms that joined J-MELODIC. The decrease in plasma BNP levels was larger in the Azosemide group than in the furosemide group ( p
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changes in brain natriuretic peptide in chronic heart failure patients treated with long acting versus short acting loop diuretics j melodic subanalysis
Heart and Vessels, 2017Co-Authors: Miho Fukui, Takeshi Tsujino, Shinichi Hirotani, Hiroshi Ito, Kazuhiro Yamamoto, Takashi Akasaka, Yutaka Hirano, Nobuyuki Ohte, Takashi Daimon, Satoshi NakataniAbstract:We have previously reported that a long-acting loop diuretic, Azosemide, reduces cardiovascular risks in patients with chronic heart failure (CHF) as compared with a short-acting one, furosemide, in Japanese Multicenter Evaluation of LOng- versus short-acting Diuretics In Congestive heart failure (J-MELODIC). However, the mechanisms of the difference have not been elucidated. This study aimed to examine whether there is a difference in the reduction in plasma brain natriuretic peptide (BNP) level and in left ventricular (LV) functional recovery between the CHF patients treated with the long-acting diuretic (the Azosemide group) and the short-acting diuretic (the furosemide group). We reviewed changes in plasma BNP level and echo-assessed LV functional parameters from baseline to a year after the entry in 288 CHF patients with New York Heart Association class II or III symptoms that joined J-MELODIC. The decrease in plasma BNP levels was larger in the Azosemide group than in the furosemide group (p < 0.01). The changes in echocardiographic parameters were not more favorable in the Azosemide group than in the furosemide group. In conclusion, the decrease in plasma BNP levels was larger in the Azosemide group than in the furosemide group. These findings may account for the better prognosis in CHF patients treated with Azosemide than those with furosemide in J-MELODIC.
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abstract 13490 Azosemide a long acting loop diuretic is superior to furosemide in prevention of cardiovascular death in heart failure patients without beta blockade
Circulation, 2013Co-Authors: Miho Fukui, Takeshi Tsujino, Shinichi Hirotani, Hiroshi Ito, Kazuhiro Yamamoto, Takashi Akasaka, Yutaka Hirano, Nobuyuki Ohte, Takashi Daimon, Satoshi NakataniAbstract:Introduction: We have previously reported that a long-acting loop diuretic, Azosemide, reduces a composite of cardiovascular death or unplanned admission to hospital for congestive heart failure in patients with chronic heart failure (CHF) as compared with short-acting one, furosemide, in Japanese Multicenter Evaluation of LOng- versus short-acting Diuretics In Congestive heart failure (J-MELODIC, Circ J. 2012; 76: 833-42). It might be due to the less activation of sympathetic nervous system in the long-acting diuretic group than in the short-acting diuretic group. Hypothesis: We assessed the hypothesis that Azosemide may be better than furosemide in preventing cardiovascular death particularly in patients without beta-blockade in this subanalysis. Methods: In this multicenter, prospective, randomized, open, blinded endpoint trial, we compared effects of Azosemide and furosemide in patients with CHF with New York Heart Association class II or III symptoms. Both heart failure with reduced EF and preserved EF were enrolled. 320 patients (160 patients in each group, mean age 71 years) were followed up for a minimum of 2 years. The Cox proportional hazards regression model was used to examine the effect of Azosemide and furosemide on cardiovascular death in patients who did not receive beta-blockade. Results: 140 patients did not receive beta-blockade at randomization (74 in the furosemide group, 66 in the Azosemide group). These patients were characterized by older age (75±7 vs. 68±12) and larger LVEF (58.3±13.6 vs. 46.6±14.3) when compared to patients who received beta-blockade. In addition to gender, age (71 years or more), and LVEF (less than 50%), BUN (20 mg/dL or more), eGFR (60 ml/min/1.73m2 or less), Azosemide or furosemide, and anemia (less than 13 g/dL in male, less than 12 g/dL in female) were selected as covariates in the Cox proportional hazards regression model based on univariate analysis. Cardiovascular death occurred in 3 patients in the Azosemide group and 8 patients in the furosemide group (hazard ratio, 0.20, 95% confidence interval, 0.05 to 0.90: p = 0.036). Conclusions: The use of long-acting diuretic rather than short-acting one is recommended in patients with CHF without beta-blockade.
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superiority of long acting to short acting loop diuretics in the treatment of congestive heart failure
Circulation, 2012Co-Authors: Tohru Masuyama, Takeshi Tsujino, Kazuhiro Yamamoto, Takashi Akasaka, Yutaka Hirano, Nobuyuki Ohte, Takashi Daimon, Satoshi Nakatani, Hideki Origasa, Hiroshi ItoAbstract:Background: Diuretics are the most prescribed drug in heart failure (HF) patients. However, clinical evidence about their long-term effects is lacking. The purpose of this study was to compare the therapeutic effects of furosemide and Azosemide, a short- and long-acting loop diuretic, respectively, in patients with chronic heart failure (CHF). Methods and Results: In this multicenter, prospective, randomized, open, blinded endpoint trial, we compared the effects of Azosemide and furosemide in patients with CHF and New York Heart Association class II or III symptoms. 320 patients (160 patients in each group, mean age 71 years) were followed up for a minimum of 2 years. The primary endpoint was a composite of cardiovascular death or unplanned admission to hospital for congestive HF. During a median follow-up of 35.2 months, the primary endpoint occurred in 23 patients in the Azosemide group and in 34 patients in the furosemide group (hazard ratio [HR], 0.55, 95% confidence interval [CI] 0.32-0.95: P=0.03). Among the secondary endpoints, unplanned admission to hospital for congestive HF or a need for modification of the treatment for HF were also reduced in the Azosemide group compared with the furosemide group (HR, 0.60, 95%CI 0.36-0.99: P=0.048). Conclusions: Azosemide, compared with furosemide, reduced the risk of cardiovascular death or unplanned admission to hospital for congestive HF. (Circ J 2012; 76: 833-842)
Kazuhiro Yamamoto - One of the best experts on this subject based on the ideXlab platform.
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Changes in brain natriuretic peptide in chronic heart failure patients treated with long-acting versus short-acting loop diuretics: J-MELODIC subanalysis
Heart and Vessels, 2017Co-Authors: Miho Fukui, Takeshi Tsujino, Shinichi Hirotani, Hiroshi Ito, Kazuhiro Yamamoto, Takashi Akasaka, Yutaka Hirano, Nobuyuki Ohte, Takashi Daimon, Satoshi NakataniAbstract:We have previously reported that a long-acting loop diuretic, Azosemide, reduces cardiovascular risks in patients with chronic heart failure (CHF) as compared with a short-acting one, furosemide, in Japanese Multicenter Evaluation of LOng- versus short-acting Diuretics In Congestive heart failure (J-MELODIC). However, the mechanisms of the difference have not been elucidated. This study aimed to examine whether there is a difference in the reduction in plasma brain natriuretic peptide (BNP) level and in left ventricular (LV) functional recovery between the CHF patients treated with the long-acting diuretic (the Azosemide group) and the short-acting diuretic (the furosemide group). We reviewed changes in plasma BNP level and echo-assessed LV functional parameters from baseline to a year after the entry in 288 CHF patients with New York Heart Association class II or III symptoms that joined J-MELODIC. The decrease in plasma BNP levels was larger in the Azosemide group than in the furosemide group ( p
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changes in brain natriuretic peptide in chronic heart failure patients treated with long acting versus short acting loop diuretics j melodic subanalysis
Heart and Vessels, 2017Co-Authors: Miho Fukui, Takeshi Tsujino, Shinichi Hirotani, Hiroshi Ito, Kazuhiro Yamamoto, Takashi Akasaka, Yutaka Hirano, Nobuyuki Ohte, Takashi Daimon, Satoshi NakataniAbstract:We have previously reported that a long-acting loop diuretic, Azosemide, reduces cardiovascular risks in patients with chronic heart failure (CHF) as compared with a short-acting one, furosemide, in Japanese Multicenter Evaluation of LOng- versus short-acting Diuretics In Congestive heart failure (J-MELODIC). However, the mechanisms of the difference have not been elucidated. This study aimed to examine whether there is a difference in the reduction in plasma brain natriuretic peptide (BNP) level and in left ventricular (LV) functional recovery between the CHF patients treated with the long-acting diuretic (the Azosemide group) and the short-acting diuretic (the furosemide group). We reviewed changes in plasma BNP level and echo-assessed LV functional parameters from baseline to a year after the entry in 288 CHF patients with New York Heart Association class II or III symptoms that joined J-MELODIC. The decrease in plasma BNP levels was larger in the Azosemide group than in the furosemide group (p < 0.01). The changes in echocardiographic parameters were not more favorable in the Azosemide group than in the furosemide group. In conclusion, the decrease in plasma BNP levels was larger in the Azosemide group than in the furosemide group. These findings may account for the better prognosis in CHF patients treated with Azosemide than those with furosemide in J-MELODIC.
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abstract 13490 Azosemide a long acting loop diuretic is superior to furosemide in prevention of cardiovascular death in heart failure patients without beta blockade
Circulation, 2013Co-Authors: Miho Fukui, Takeshi Tsujino, Shinichi Hirotani, Hiroshi Ito, Kazuhiro Yamamoto, Takashi Akasaka, Yutaka Hirano, Nobuyuki Ohte, Takashi Daimon, Satoshi NakataniAbstract:Introduction: We have previously reported that a long-acting loop diuretic, Azosemide, reduces a composite of cardiovascular death or unplanned admission to hospital for congestive heart failure in patients with chronic heart failure (CHF) as compared with short-acting one, furosemide, in Japanese Multicenter Evaluation of LOng- versus short-acting Diuretics In Congestive heart failure (J-MELODIC, Circ J. 2012; 76: 833-42). It might be due to the less activation of sympathetic nervous system in the long-acting diuretic group than in the short-acting diuretic group. Hypothesis: We assessed the hypothesis that Azosemide may be better than furosemide in preventing cardiovascular death particularly in patients without beta-blockade in this subanalysis. Methods: In this multicenter, prospective, randomized, open, blinded endpoint trial, we compared effects of Azosemide and furosemide in patients with CHF with New York Heart Association class II or III symptoms. Both heart failure with reduced EF and preserved EF were enrolled. 320 patients (160 patients in each group, mean age 71 years) were followed up for a minimum of 2 years. The Cox proportional hazards regression model was used to examine the effect of Azosemide and furosemide on cardiovascular death in patients who did not receive beta-blockade. Results: 140 patients did not receive beta-blockade at randomization (74 in the furosemide group, 66 in the Azosemide group). These patients were characterized by older age (75±7 vs. 68±12) and larger LVEF (58.3±13.6 vs. 46.6±14.3) when compared to patients who received beta-blockade. In addition to gender, age (71 years or more), and LVEF (less than 50%), BUN (20 mg/dL or more), eGFR (60 ml/min/1.73m2 or less), Azosemide or furosemide, and anemia (less than 13 g/dL in male, less than 12 g/dL in female) were selected as covariates in the Cox proportional hazards regression model based on univariate analysis. Cardiovascular death occurred in 3 patients in the Azosemide group and 8 patients in the furosemide group (hazard ratio, 0.20, 95% confidence interval, 0.05 to 0.90: p = 0.036). Conclusions: The use of long-acting diuretic rather than short-acting one is recommended in patients with CHF without beta-blockade.
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superiority of long acting to short acting loop diuretics in the treatment of congestive heart failure
Circulation, 2012Co-Authors: Tohru Masuyama, Takeshi Tsujino, Kazuhiro Yamamoto, Takashi Akasaka, Yutaka Hirano, Nobuyuki Ohte, Takashi Daimon, Satoshi Nakatani, Hideki Origasa, Hiroshi ItoAbstract:Background: Diuretics are the most prescribed drug in heart failure (HF) patients. However, clinical evidence about their long-term effects is lacking. The purpose of this study was to compare the therapeutic effects of furosemide and Azosemide, a short- and long-acting loop diuretic, respectively, in patients with chronic heart failure (CHF). Methods and Results: In this multicenter, prospective, randomized, open, blinded endpoint trial, we compared the effects of Azosemide and furosemide in patients with CHF and New York Heart Association class II or III symptoms. 320 patients (160 patients in each group, mean age 71 years) were followed up for a minimum of 2 years. The primary endpoint was a composite of cardiovascular death or unplanned admission to hospital for congestive HF. During a median follow-up of 35.2 months, the primary endpoint occurred in 23 patients in the Azosemide group and in 34 patients in the furosemide group (hazard ratio [HR], 0.55, 95% confidence interval [CI] 0.32-0.95: P=0.03). Among the secondary endpoints, unplanned admission to hospital for congestive HF or a need for modification of the treatment for HF were also reduced in the Azosemide group compared with the furosemide group (HR, 0.60, 95%CI 0.36-0.99: P=0.048). Conclusions: Azosemide, compared with furosemide, reduced the risk of cardiovascular death or unplanned admission to hospital for congestive HF. (Circ J 2012; 76: 833-842)
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different effects of long and short acting loop diuretics on survival rate in dahl high salt heart failure model rats
Cardiovascular Research, 2005Co-Authors: Junichi Yoshida, Kazuhiro Yamamoto, Toshiaki Mano, Yasushi Sakata, Mayu Nishio, Tomohito Ohtani, Masatsugu Hori, Takeshi Miwa, Tohru MasuyamaAbstract:Objectives: We compared therapeutic effects of furosemide, a short-acting loop diuretic, and Azosemide, a long-acting one, in hypertensive heart failure rats to test the hypothesis that long-acting diuretics are superior to short-acting types in heart failure. Methods: Dahl salt-sensitive rats fed an 8% NaCl diet from age 8 weeks were divided at age 21 weeks (compensated hypertrophic stage) into three groups: rats treated with furosemide (40 mg/kg/day), those treated with Azosemide (80 mg/kg/day) and untreated rats. Rats fed a 0.3% NaCl diet served as controls. Results: Both medications prevented left ventricular systolic dysfunction and enlargement at age 31 weeks, and attenuated macrophage infiltration, reactive oxygen species generation, and gelatinolytic activity to the same degree. Azosemide suppressed left ventricular fibrosis to the control level, but furosemide did not. Azosemide ameliorated myocardial catecholamine depletion and improved survival rate. Furosemide increased plasma norepinephrine levels and did not exert such beneficial effects. Conclusions: Azosemide provided better prognosis in heart failure rats compared with furosemide, partly through attenuation of the reflex increase in cardiac sympathetic neuronal activity caused by the development of heart failure. The current findings suggest a need for clinical trials examining whether long- and short-acting diuretics provide a different prognosis in patients with heart failure.
Hiroshi Ito - One of the best experts on this subject based on the ideXlab platform.
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Changes in brain natriuretic peptide in chronic heart failure patients treated with long-acting versus short-acting loop diuretics: J-MELODIC subanalysis
Heart and Vessels, 2017Co-Authors: Miho Fukui, Takeshi Tsujino, Shinichi Hirotani, Hiroshi Ito, Kazuhiro Yamamoto, Takashi Akasaka, Yutaka Hirano, Nobuyuki Ohte, Takashi Daimon, Satoshi NakataniAbstract:We have previously reported that a long-acting loop diuretic, Azosemide, reduces cardiovascular risks in patients with chronic heart failure (CHF) as compared with a short-acting one, furosemide, in Japanese Multicenter Evaluation of LOng- versus short-acting Diuretics In Congestive heart failure (J-MELODIC). However, the mechanisms of the difference have not been elucidated. This study aimed to examine whether there is a difference in the reduction in plasma brain natriuretic peptide (BNP) level and in left ventricular (LV) functional recovery between the CHF patients treated with the long-acting diuretic (the Azosemide group) and the short-acting diuretic (the furosemide group). We reviewed changes in plasma BNP level and echo-assessed LV functional parameters from baseline to a year after the entry in 288 CHF patients with New York Heart Association class II or III symptoms that joined J-MELODIC. The decrease in plasma BNP levels was larger in the Azosemide group than in the furosemide group ( p
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changes in brain natriuretic peptide in chronic heart failure patients treated with long acting versus short acting loop diuretics j melodic subanalysis
Heart and Vessels, 2017Co-Authors: Miho Fukui, Takeshi Tsujino, Shinichi Hirotani, Hiroshi Ito, Kazuhiro Yamamoto, Takashi Akasaka, Yutaka Hirano, Nobuyuki Ohte, Takashi Daimon, Satoshi NakataniAbstract:We have previously reported that a long-acting loop diuretic, Azosemide, reduces cardiovascular risks in patients with chronic heart failure (CHF) as compared with a short-acting one, furosemide, in Japanese Multicenter Evaluation of LOng- versus short-acting Diuretics In Congestive heart failure (J-MELODIC). However, the mechanisms of the difference have not been elucidated. This study aimed to examine whether there is a difference in the reduction in plasma brain natriuretic peptide (BNP) level and in left ventricular (LV) functional recovery between the CHF patients treated with the long-acting diuretic (the Azosemide group) and the short-acting diuretic (the furosemide group). We reviewed changes in plasma BNP level and echo-assessed LV functional parameters from baseline to a year after the entry in 288 CHF patients with New York Heart Association class II or III symptoms that joined J-MELODIC. The decrease in plasma BNP levels was larger in the Azosemide group than in the furosemide group (p < 0.01). The changes in echocardiographic parameters were not more favorable in the Azosemide group than in the furosemide group. In conclusion, the decrease in plasma BNP levels was larger in the Azosemide group than in the furosemide group. These findings may account for the better prognosis in CHF patients treated with Azosemide than those with furosemide in J-MELODIC.
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abstract 13490 Azosemide a long acting loop diuretic is superior to furosemide in prevention of cardiovascular death in heart failure patients without beta blockade
Circulation, 2013Co-Authors: Miho Fukui, Takeshi Tsujino, Shinichi Hirotani, Hiroshi Ito, Kazuhiro Yamamoto, Takashi Akasaka, Yutaka Hirano, Nobuyuki Ohte, Takashi Daimon, Satoshi NakataniAbstract:Introduction: We have previously reported that a long-acting loop diuretic, Azosemide, reduces a composite of cardiovascular death or unplanned admission to hospital for congestive heart failure in patients with chronic heart failure (CHF) as compared with short-acting one, furosemide, in Japanese Multicenter Evaluation of LOng- versus short-acting Diuretics In Congestive heart failure (J-MELODIC, Circ J. 2012; 76: 833-42). It might be due to the less activation of sympathetic nervous system in the long-acting diuretic group than in the short-acting diuretic group. Hypothesis: We assessed the hypothesis that Azosemide may be better than furosemide in preventing cardiovascular death particularly in patients without beta-blockade in this subanalysis. Methods: In this multicenter, prospective, randomized, open, blinded endpoint trial, we compared effects of Azosemide and furosemide in patients with CHF with New York Heart Association class II or III symptoms. Both heart failure with reduced EF and preserved EF were enrolled. 320 patients (160 patients in each group, mean age 71 years) were followed up for a minimum of 2 years. The Cox proportional hazards regression model was used to examine the effect of Azosemide and furosemide on cardiovascular death in patients who did not receive beta-blockade. Results: 140 patients did not receive beta-blockade at randomization (74 in the furosemide group, 66 in the Azosemide group). These patients were characterized by older age (75±7 vs. 68±12) and larger LVEF (58.3±13.6 vs. 46.6±14.3) when compared to patients who received beta-blockade. In addition to gender, age (71 years or more), and LVEF (less than 50%), BUN (20 mg/dL or more), eGFR (60 ml/min/1.73m2 or less), Azosemide or furosemide, and anemia (less than 13 g/dL in male, less than 12 g/dL in female) were selected as covariates in the Cox proportional hazards regression model based on univariate analysis. Cardiovascular death occurred in 3 patients in the Azosemide group and 8 patients in the furosemide group (hazard ratio, 0.20, 95% confidence interval, 0.05 to 0.90: p = 0.036). Conclusions: The use of long-acting diuretic rather than short-acting one is recommended in patients with CHF without beta-blockade.
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superiority of long acting to short acting loop diuretics in the treatment of congestive heart failure
Circulation, 2012Co-Authors: Tohru Masuyama, Takeshi Tsujino, Kazuhiro Yamamoto, Takashi Akasaka, Yutaka Hirano, Nobuyuki Ohte, Takashi Daimon, Satoshi Nakatani, Hideki Origasa, Hiroshi ItoAbstract:Background: Diuretics are the most prescribed drug in heart failure (HF) patients. However, clinical evidence about their long-term effects is lacking. The purpose of this study was to compare the therapeutic effects of furosemide and Azosemide, a short- and long-acting loop diuretic, respectively, in patients with chronic heart failure (CHF). Methods and Results: In this multicenter, prospective, randomized, open, blinded endpoint trial, we compared the effects of Azosemide and furosemide in patients with CHF and New York Heart Association class II or III symptoms. 320 patients (160 patients in each group, mean age 71 years) were followed up for a minimum of 2 years. The primary endpoint was a composite of cardiovascular death or unplanned admission to hospital for congestive HF. During a median follow-up of 35.2 months, the primary endpoint occurred in 23 patients in the Azosemide group and in 34 patients in the furosemide group (hazard ratio [HR], 0.55, 95% confidence interval [CI] 0.32-0.95: P=0.03). Among the secondary endpoints, unplanned admission to hospital for congestive HF or a need for modification of the treatment for HF were also reduced in the Azosemide group compared with the furosemide group (HR, 0.60, 95%CI 0.36-0.99: P=0.048). Conclusions: Azosemide, compared with furosemide, reduced the risk of cardiovascular death or unplanned admission to hospital for congestive HF. (Circ J 2012; 76: 833-842)
Yutaka Hirano - One of the best experts on this subject based on the ideXlab platform.
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Changes in brain natriuretic peptide in chronic heart failure patients treated with long-acting versus short-acting loop diuretics: J-MELODIC subanalysis
Heart and Vessels, 2017Co-Authors: Miho Fukui, Takeshi Tsujino, Shinichi Hirotani, Hiroshi Ito, Kazuhiro Yamamoto, Takashi Akasaka, Yutaka Hirano, Nobuyuki Ohte, Takashi Daimon, Satoshi NakataniAbstract:We have previously reported that a long-acting loop diuretic, Azosemide, reduces cardiovascular risks in patients with chronic heart failure (CHF) as compared with a short-acting one, furosemide, in Japanese Multicenter Evaluation of LOng- versus short-acting Diuretics In Congestive heart failure (J-MELODIC). However, the mechanisms of the difference have not been elucidated. This study aimed to examine whether there is a difference in the reduction in plasma brain natriuretic peptide (BNP) level and in left ventricular (LV) functional recovery between the CHF patients treated with the long-acting diuretic (the Azosemide group) and the short-acting diuretic (the furosemide group). We reviewed changes in plasma BNP level and echo-assessed LV functional parameters from baseline to a year after the entry in 288 CHF patients with New York Heart Association class II or III symptoms that joined J-MELODIC. The decrease in plasma BNP levels was larger in the Azosemide group than in the furosemide group ( p
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changes in brain natriuretic peptide in chronic heart failure patients treated with long acting versus short acting loop diuretics j melodic subanalysis
Heart and Vessels, 2017Co-Authors: Miho Fukui, Takeshi Tsujino, Shinichi Hirotani, Hiroshi Ito, Kazuhiro Yamamoto, Takashi Akasaka, Yutaka Hirano, Nobuyuki Ohte, Takashi Daimon, Satoshi NakataniAbstract:We have previously reported that a long-acting loop diuretic, Azosemide, reduces cardiovascular risks in patients with chronic heart failure (CHF) as compared with a short-acting one, furosemide, in Japanese Multicenter Evaluation of LOng- versus short-acting Diuretics In Congestive heart failure (J-MELODIC). However, the mechanisms of the difference have not been elucidated. This study aimed to examine whether there is a difference in the reduction in plasma brain natriuretic peptide (BNP) level and in left ventricular (LV) functional recovery between the CHF patients treated with the long-acting diuretic (the Azosemide group) and the short-acting diuretic (the furosemide group). We reviewed changes in plasma BNP level and echo-assessed LV functional parameters from baseline to a year after the entry in 288 CHF patients with New York Heart Association class II or III symptoms that joined J-MELODIC. The decrease in plasma BNP levels was larger in the Azosemide group than in the furosemide group (p < 0.01). The changes in echocardiographic parameters were not more favorable in the Azosemide group than in the furosemide group. In conclusion, the decrease in plasma BNP levels was larger in the Azosemide group than in the furosemide group. These findings may account for the better prognosis in CHF patients treated with Azosemide than those with furosemide in J-MELODIC.
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abstract 13490 Azosemide a long acting loop diuretic is superior to furosemide in prevention of cardiovascular death in heart failure patients without beta blockade
Circulation, 2013Co-Authors: Miho Fukui, Takeshi Tsujino, Shinichi Hirotani, Hiroshi Ito, Kazuhiro Yamamoto, Takashi Akasaka, Yutaka Hirano, Nobuyuki Ohte, Takashi Daimon, Satoshi NakataniAbstract:Introduction: We have previously reported that a long-acting loop diuretic, Azosemide, reduces a composite of cardiovascular death or unplanned admission to hospital for congestive heart failure in patients with chronic heart failure (CHF) as compared with short-acting one, furosemide, in Japanese Multicenter Evaluation of LOng- versus short-acting Diuretics In Congestive heart failure (J-MELODIC, Circ J. 2012; 76: 833-42). It might be due to the less activation of sympathetic nervous system in the long-acting diuretic group than in the short-acting diuretic group. Hypothesis: We assessed the hypothesis that Azosemide may be better than furosemide in preventing cardiovascular death particularly in patients without beta-blockade in this subanalysis. Methods: In this multicenter, prospective, randomized, open, blinded endpoint trial, we compared effects of Azosemide and furosemide in patients with CHF with New York Heart Association class II or III symptoms. Both heart failure with reduced EF and preserved EF were enrolled. 320 patients (160 patients in each group, mean age 71 years) were followed up for a minimum of 2 years. The Cox proportional hazards regression model was used to examine the effect of Azosemide and furosemide on cardiovascular death in patients who did not receive beta-blockade. Results: 140 patients did not receive beta-blockade at randomization (74 in the furosemide group, 66 in the Azosemide group). These patients were characterized by older age (75±7 vs. 68±12) and larger LVEF (58.3±13.6 vs. 46.6±14.3) when compared to patients who received beta-blockade. In addition to gender, age (71 years or more), and LVEF (less than 50%), BUN (20 mg/dL or more), eGFR (60 ml/min/1.73m2 or less), Azosemide or furosemide, and anemia (less than 13 g/dL in male, less than 12 g/dL in female) were selected as covariates in the Cox proportional hazards regression model based on univariate analysis. Cardiovascular death occurred in 3 patients in the Azosemide group and 8 patients in the furosemide group (hazard ratio, 0.20, 95% confidence interval, 0.05 to 0.90: p = 0.036). Conclusions: The use of long-acting diuretic rather than short-acting one is recommended in patients with CHF without beta-blockade.
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superiority of long acting to short acting loop diuretics in the treatment of congestive heart failure
Circulation, 2012Co-Authors: Tohru Masuyama, Takeshi Tsujino, Kazuhiro Yamamoto, Takashi Akasaka, Yutaka Hirano, Nobuyuki Ohte, Takashi Daimon, Satoshi Nakatani, Hideki Origasa, Hiroshi ItoAbstract:Background: Diuretics are the most prescribed drug in heart failure (HF) patients. However, clinical evidence about their long-term effects is lacking. The purpose of this study was to compare the therapeutic effects of furosemide and Azosemide, a short- and long-acting loop diuretic, respectively, in patients with chronic heart failure (CHF). Methods and Results: In this multicenter, prospective, randomized, open, blinded endpoint trial, we compared the effects of Azosemide and furosemide in patients with CHF and New York Heart Association class II or III symptoms. 320 patients (160 patients in each group, mean age 71 years) were followed up for a minimum of 2 years. The primary endpoint was a composite of cardiovascular death or unplanned admission to hospital for congestive HF. During a median follow-up of 35.2 months, the primary endpoint occurred in 23 patients in the Azosemide group and in 34 patients in the furosemide group (hazard ratio [HR], 0.55, 95% confidence interval [CI] 0.32-0.95: P=0.03). Among the secondary endpoints, unplanned admission to hospital for congestive HF or a need for modification of the treatment for HF were also reduced in the Azosemide group compared with the furosemide group (HR, 0.60, 95%CI 0.36-0.99: P=0.048). Conclusions: Azosemide, compared with furosemide, reduced the risk of cardiovascular death or unplanned admission to hospital for congestive HF. (Circ J 2012; 76: 833-842)
Takashi Akasaka - One of the best experts on this subject based on the ideXlab platform.
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Changes in brain natriuretic peptide in chronic heart failure patients treated with long-acting versus short-acting loop diuretics: J-MELODIC subanalysis
Heart and Vessels, 2017Co-Authors: Miho Fukui, Takeshi Tsujino, Shinichi Hirotani, Hiroshi Ito, Kazuhiro Yamamoto, Takashi Akasaka, Yutaka Hirano, Nobuyuki Ohte, Takashi Daimon, Satoshi NakataniAbstract:We have previously reported that a long-acting loop diuretic, Azosemide, reduces cardiovascular risks in patients with chronic heart failure (CHF) as compared with a short-acting one, furosemide, in Japanese Multicenter Evaluation of LOng- versus short-acting Diuretics In Congestive heart failure (J-MELODIC). However, the mechanisms of the difference have not been elucidated. This study aimed to examine whether there is a difference in the reduction in plasma brain natriuretic peptide (BNP) level and in left ventricular (LV) functional recovery between the CHF patients treated with the long-acting diuretic (the Azosemide group) and the short-acting diuretic (the furosemide group). We reviewed changes in plasma BNP level and echo-assessed LV functional parameters from baseline to a year after the entry in 288 CHF patients with New York Heart Association class II or III symptoms that joined J-MELODIC. The decrease in plasma BNP levels was larger in the Azosemide group than in the furosemide group ( p
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changes in brain natriuretic peptide in chronic heart failure patients treated with long acting versus short acting loop diuretics j melodic subanalysis
Heart and Vessels, 2017Co-Authors: Miho Fukui, Takeshi Tsujino, Shinichi Hirotani, Hiroshi Ito, Kazuhiro Yamamoto, Takashi Akasaka, Yutaka Hirano, Nobuyuki Ohte, Takashi Daimon, Satoshi NakataniAbstract:We have previously reported that a long-acting loop diuretic, Azosemide, reduces cardiovascular risks in patients with chronic heart failure (CHF) as compared with a short-acting one, furosemide, in Japanese Multicenter Evaluation of LOng- versus short-acting Diuretics In Congestive heart failure (J-MELODIC). However, the mechanisms of the difference have not been elucidated. This study aimed to examine whether there is a difference in the reduction in plasma brain natriuretic peptide (BNP) level and in left ventricular (LV) functional recovery between the CHF patients treated with the long-acting diuretic (the Azosemide group) and the short-acting diuretic (the furosemide group). We reviewed changes in plasma BNP level and echo-assessed LV functional parameters from baseline to a year after the entry in 288 CHF patients with New York Heart Association class II or III symptoms that joined J-MELODIC. The decrease in plasma BNP levels was larger in the Azosemide group than in the furosemide group (p < 0.01). The changes in echocardiographic parameters were not more favorable in the Azosemide group than in the furosemide group. In conclusion, the decrease in plasma BNP levels was larger in the Azosemide group than in the furosemide group. These findings may account for the better prognosis in CHF patients treated with Azosemide than those with furosemide in J-MELODIC.
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abstract 13490 Azosemide a long acting loop diuretic is superior to furosemide in prevention of cardiovascular death in heart failure patients without beta blockade
Circulation, 2013Co-Authors: Miho Fukui, Takeshi Tsujino, Shinichi Hirotani, Hiroshi Ito, Kazuhiro Yamamoto, Takashi Akasaka, Yutaka Hirano, Nobuyuki Ohte, Takashi Daimon, Satoshi NakataniAbstract:Introduction: We have previously reported that a long-acting loop diuretic, Azosemide, reduces a composite of cardiovascular death or unplanned admission to hospital for congestive heart failure in patients with chronic heart failure (CHF) as compared with short-acting one, furosemide, in Japanese Multicenter Evaluation of LOng- versus short-acting Diuretics In Congestive heart failure (J-MELODIC, Circ J. 2012; 76: 833-42). It might be due to the less activation of sympathetic nervous system in the long-acting diuretic group than in the short-acting diuretic group. Hypothesis: We assessed the hypothesis that Azosemide may be better than furosemide in preventing cardiovascular death particularly in patients without beta-blockade in this subanalysis. Methods: In this multicenter, prospective, randomized, open, blinded endpoint trial, we compared effects of Azosemide and furosemide in patients with CHF with New York Heart Association class II or III symptoms. Both heart failure with reduced EF and preserved EF were enrolled. 320 patients (160 patients in each group, mean age 71 years) were followed up for a minimum of 2 years. The Cox proportional hazards regression model was used to examine the effect of Azosemide and furosemide on cardiovascular death in patients who did not receive beta-blockade. Results: 140 patients did not receive beta-blockade at randomization (74 in the furosemide group, 66 in the Azosemide group). These patients were characterized by older age (75±7 vs. 68±12) and larger LVEF (58.3±13.6 vs. 46.6±14.3) when compared to patients who received beta-blockade. In addition to gender, age (71 years or more), and LVEF (less than 50%), BUN (20 mg/dL or more), eGFR (60 ml/min/1.73m2 or less), Azosemide or furosemide, and anemia (less than 13 g/dL in male, less than 12 g/dL in female) were selected as covariates in the Cox proportional hazards regression model based on univariate analysis. Cardiovascular death occurred in 3 patients in the Azosemide group and 8 patients in the furosemide group (hazard ratio, 0.20, 95% confidence interval, 0.05 to 0.90: p = 0.036). Conclusions: The use of long-acting diuretic rather than short-acting one is recommended in patients with CHF without beta-blockade.
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superiority of long acting to short acting loop diuretics in the treatment of congestive heart failure
Circulation, 2012Co-Authors: Tohru Masuyama, Takeshi Tsujino, Kazuhiro Yamamoto, Takashi Akasaka, Yutaka Hirano, Nobuyuki Ohte, Takashi Daimon, Satoshi Nakatani, Hideki Origasa, Hiroshi ItoAbstract:Background: Diuretics are the most prescribed drug in heart failure (HF) patients. However, clinical evidence about their long-term effects is lacking. The purpose of this study was to compare the therapeutic effects of furosemide and Azosemide, a short- and long-acting loop diuretic, respectively, in patients with chronic heart failure (CHF). Methods and Results: In this multicenter, prospective, randomized, open, blinded endpoint trial, we compared the effects of Azosemide and furosemide in patients with CHF and New York Heart Association class II or III symptoms. 320 patients (160 patients in each group, mean age 71 years) were followed up for a minimum of 2 years. The primary endpoint was a composite of cardiovascular death or unplanned admission to hospital for congestive HF. During a median follow-up of 35.2 months, the primary endpoint occurred in 23 patients in the Azosemide group and in 34 patients in the furosemide group (hazard ratio [HR], 0.55, 95% confidence interval [CI] 0.32-0.95: P=0.03). Among the secondary endpoints, unplanned admission to hospital for congestive HF or a need for modification of the treatment for HF were also reduced in the Azosemide group compared with the furosemide group (HR, 0.60, 95%CI 0.36-0.99: P=0.048). Conclusions: Azosemide, compared with furosemide, reduced the risk of cardiovascular death or unplanned admission to hospital for congestive HF. (Circ J 2012; 76: 833-842)