Influence of cardiac function on the diuretic and hemodynamic effects of the loop diuretic piretanide

G. Hasenfuss, C. Holubarsch, C. Herzog, H. Knauf, H. Just, H. Spahn, E. Mutschler

Research output: Contribution to journalArticlepeer-review

19 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)83-88
Number of pages6
JournalClinical Cardiology
Volume10
Issue number2
DOIs
StatePublished - Feb 1987

Keywords

  • congestive heart failure
  • diuretic resistance
  • hemodynamics
  • loop diuretics
  • piretanide
  • venous dilatation

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