scholarly journals Short-term hemodynamic effects of nebivolol in acute decompensated heart failure: a randomized clinical trial

Critical Care ◽  
2012 ◽  
Vol 16 (S1) ◽  
Author(s):  
R Puig ◽  
M Ochiai ◽  
J Cardoso ◽  
K Vieira ◽  
E Brancalhao ◽  
...  
Keyword(s):  
Heart Failure ◽  
Clinical Trial ◽  
Randomized Clinical Trial ◽  
Acute Decompensated Heart Failure ◽  
Decompensated Heart Failure ◽  
Hemodynamic Effects ◽  
Short Term

scholarly journals Effect of adding hydrochlorothiazide to usual treatment of patients with acute decompensated heart failure: a randomized clinical trial

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Diogo Silva Piardi ◽  
Maurício Butzke ◽  
Ana Carolina Martins Mazzuca ◽  
Bruna Sessim Gomes ◽  
Sofia Giusti Alves ◽  
...  
Keyword(s):  
Heart Failure ◽  
Clinical Trial ◽  
Randomized Clinical Trial ◽  
Weight Reduction ◽  
Acute Decompensated Heart Failure ◽  
Decompensated Heart Failure ◽  
World Health ◽  
Clinical Trial Registry ◽  
Usual Treatment ◽  
Significant Difference

AbstractAcute decompensated heart failure (ADHF) is the leading cause of hospitalization in patients aged 65 years or older, and most of them present with congestion. The use of hydrochlorothiazide (HCTZ) may increase the response to loop diuretics. To evaluate the effect of adding HCTZ to furosemide on congestion and symptoms in patients with ADHF. This randomized clinical trial compared HCTZ 50 mg versus placebo for 3 days in patients with ADHF and signs of congestion. The primary outcome of the study was daily weight reduction. Secondary outcomes were change in creatinine, need for vasoactive drugs, change in natriuretic peptides, congestion score, dyspnea, thirst, and length of stay. Fifty-one patients were randomized—26 to the HCTZ group and 25 to the placebo group. There was an increment of 0.73 kg/day towards additional weight reduction in the HCTZ group (HCTZ: − 1.78 ± 1.08 kg/day vs placebo: − 1.05 ± 1.51 kg/day; p = 0.062). In post hoc analysis, the HCTZ group demonstrated significant weight reduction for every 40 mg of intravenous furosemide (HCTZ: − 0.74 ± 0.47 kg/40 mg vs placebo: − 0.33 ± 0.80 kg/40 mg; p = 0.032). There was a trend to increase in creatinine in the HCTZ group (HCTZ: 0.50 ± 0.37 vs placebo: 0.27 ± 0.40; p = 0.05) but no significant difference in onset of acute renal failure (HCTZ: 58% vs placebo: 41%; p = 0.38). No differences were found in the remaining outcomes. Adding hydrochlorothiazide to usual treatment of patients with acute decompensated heart failure did not cause significant difference in daily body weight reduction compared to placebo. In analysis adjusted to the dose of intravenous furosemide, adding HCTZ 50 mg to furosemide resulted in a significant synergistic effect on weight loss.Trial registration: The Brazilian Clinical Trials Registry (ReBEC), a publically accessible primary register that participates in the World Health Organization International Clinical Trial Registry Platform; number RBR-5qkn8h. Registered in 23/07/2019 (retrospectively), http://www.ensaiosclinicos.gov.br/rg/RBR-5qkn8h/.

scholarly journals Effect of adding hydrochlorothiazide to usual treatment of patients with acute decompensated heart failure: a randomized clinical trial

2021 ◽  
Vol 10 (Supplement_1) ◽  
Author(s):  
D Piardi ◽  
M Butzke ◽  
ACM Mazzuca ◽  
BS Gomes ◽  
SG Alves ◽  
...  
Keyword(s):  
Heart Failure ◽  
Clinical Trial ◽  
Randomized Clinical Trial ◽  
Natriuretic Peptides ◽  
Weight Reduction ◽  
Acute Decompensated Heart Failure ◽  
Decompensated Heart Failure ◽  
Vasoactive Drugs ◽  
Funding Sources ◽  
Significant Difference

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Acute decompensated heart failure (ADHF) is the leading cause of hospitalization in patients aged 65 years or older, and most of them present with congestion. The use of hydrochlorothiazide (HCTZ) may increase the response to loop diuretics. Objective: To evaluate the effect of adding HCTZ to furosemide on congestion and symptoms in patients with ADHF. Methods: This randomized clinical trial compared HCTZ 50 mg versus placebo for 3 days in patients with ADHF and signs of congestion. The primary outcome of the study was daily weight reduction. Secondary outcomes were change in creatinine, need for vasoactive drugs, change in natriuretic peptides, congestion score, dyspnea, thirst, and length of stay. Results: Fifty-one patients were randomized — 26 to the HCTZ group and 25 to the placebo group. There was a trend towards additional weight reduction in the HCTZ group (HCTZ: -1.78 ± 1.08 kg/day vs placebo: -1.05 ± 1.51 kg/day; p = 0.062). In post hoc analysis, the HCTZ group demonstrated significant weight reduction for every 40 mg of intravenous furosemide (HCTZ: -0.74 ± 0.47 kg/40 mg vs placebo: -0.33 ± 0.80 kg/40 mg; p = 0.032) - figure. There was a trend to increase in creatinine in the HCTZ group (HCTZ: 0.50 ± 0.37 vs placebo: 0.27 ± 0.40; p = 0.05) but no significant difference in onset of acute renal failure (HCTZ: 58% vs placebo: 41%; p = 0.38). No differences were found in the remaining outcomes - table. Conclusion: There was a trend towards greater daily weight reduction in the HCTZ group. In analysis adjusted to the dose of intravenous furosemide, adding HCTZ 50 mg to furosemide resulted in a synergistic effect on weight loss. Study outcomesOutcomeHCTZPlacebop-valuePrimaryWeight change/day-1.78 ± 1.08-1.05 ± 1.510.062SecondaryLength of stay (days)9 ± 88 ± 90.37Change in creatinine (mg/dL)0.50 ± 0.370.27 ± 0.400.05Need for vasoactive drugs (%)19.212.00.70Congestion score-5.4 ± 4.6-4.8 ± 4.60.68Change in dyspnea scale-4.7 ± 2.7-3.2 ± 3.60.14Thirst scale-1.7 ± 4.50.5 ± 3.80.21Change in natriuretic peptides (%)-11.1 ± 100.3-33.3 ± 50.90.83Plus–minus values are means ± standard deviation.Abstract Figure. Diuretic response

scholarly journals Effect of adding hydrochlorothiazide to usual treatment of patients with acute decompensated heart failure: a randomized clinical trial

2021 ◽  
Author(s):  
Diogo Piardi ◽  
Mauricio Butzke ◽  
Ana Carolina Mazzuca ◽  
Bruna Gomes ◽  
Sofia Alves ◽  
...  
Keyword(s):  
Heart Failure ◽  
Clinical Trial ◽  
Randomized Clinical Trial ◽  
Weight Reduction ◽  
Primary Outcome ◽  
Acute Decompensated Heart Failure ◽  
Decompensated Heart Failure ◽  
Additional Weight ◽  
Significant Difference ◽  
Post Hoc

Abstract Introduction: Acute decompensated heart failure (ADHF) is the leading cause of hospitalization in patients aged 65 years or older, and most of them present with congestion. The use of hydrochlorothiazide (HCTZ) may increase the response to loop diuretics. Objective To evaluate the effect of adding HCTZ to furosemide on congestion and symptoms in patients with ADHF. Methods This randomized clinical trial compared HCTZ 50 mg versus placebo for 3 days in patients with ADHF and signs of congestion. The primary outcome of the study was daily weight reduction. Secondary outcomes were change in creatinine, need for vasoactive drugs, change in natriuretic peptides, congestion score, dyspnea, thirst, and length of stay. Results Fifty-one patients were randomized — 26 to the HCTZ group and 25 to the placebo group. There was a trend towards additional weight reduction in the HCTZ group (HCTZ: -1.78 ± 1.08 kg/day vs placebo: -1.05 ± 1.51 kg/day; p = 0.062). In post hoc analysis, the HCTZ group demonstrated significant weight reduction for every 40 mg of intravenous furosemide (HCTZ: -0.74 ± 0.47 kg/40 mg vs placebo: -0.33 ± 0.80 kg/40 mg; p = 0.032). There was a trend to increase in creatinine in the HCTZ group (HCTZ: 0.50 ± 0.37 vs placebo: 0.27 ± 0.40; p = 0.05) but no significant difference in onset of acute renal failure (HCTZ: 58% vs placebo: 41%; p = 0.38). No differences were found in the remaining outcomes. Conclusion There was a trend towards greater daily weight reduction in the HCTZ group. In analysis adjusted to the dose of intravenous furosemide, adding HCTZ 50 mg to furosemide resulted in a significant synergistic effect on weight loss.

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