Furosemide withdrawal in elderly heart failure patients with preserved left ventricular systolic function

To explore the possibilities of furosemide withdrawal in elderly heart failure (HF) patients with intact left ventricular (LV) systolic function and assess its effects on functional status and orthostatic blood pressure homeostasis, we performed a placebo-controlled pilot trial of furosemide withdra...

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Bibliographic Details
Published in:The American journal of cardiology 2000-06, Vol.85 (12), p.1461-1466
Main Authors: van Kraaij, Dave J.W, Jansen, René W.M.M, Bouwels, Léon H.R, Gribnau, Frank W.J, Hoefnagels, Willibrord H.L
Format: Article
Language:English
Subjects:
Aged
Biological and medical sciences
Blood Pressure
Blood vessels
Cardiovascular system
Diuretics - therapeutic use
Female
Furosemide - therapeutic use
Heart failure
Heart Failure - drug therapy
Heart Failure - physiopathology
Heart Rate
Humans
Male
Medical sciences
Miscellaneous
Older people
Pharmacology. Drug treatments
Pilot Projects
Quality of Life
Spirometry
Ventricular Function, Left
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Summary:To explore the possibilities of furosemide withdrawal in elderly heart failure (HF) patients with intact left ventricular (LV) systolic function and assess its effects on functional status and orthostatic blood pressure homeostasis, we performed a placebo-controlled pilot trial of furosemide withdrawal with 3 months of follow-up in 32 HF patients (aged 75.1 ± 0.7 years [mean ± SEM]) with a LV ejection fraction of 60 ± 2% and without overt congestion. Investigations included repeated clinical assessment, spirometry, standardized 6-minute walking test, and chest x-rays. Measurements of blood pressure response on active standing and Doppler echocardiography were performed before and 3 months after furosemide withdrawal. Recurrent congestive HF occurred in 2 of 21 patients (10%) who discontinued furosemide use, and in 1 of 11 patients (9%) who continued furosemide (p = NS). Three patients restarted furosemide for ankle edema and 1 for blood pressure levels >180/100 mm Hg. After 3 months, there were no differences regarding HF symptom scores, blood pressure, heart rate, spirometric results, 6-minute walking distance, or quality of life scores between patients who discontinued use and patients who continued the therapy. In patients successfully withdrawn, Doppler E/A ratio increased from 0.68 ± 0.05 to 0.79 ± 0.06 after withdrawal (p
ISSN:0002-9149
1879-1913
DOI:10.1016/S0002-9149(00)00795-5