PMID: 8011564Dec 1, 1993

Diuretics in postinfarction heart failure

Cardiovascular Drugs and Therapy
S H Taylor

Abstract

Severe left ventricular failure, as evidenced by radiographic pulmonary edema or raised left ventricular filling pressure, accompanying acute myocardial infarction, carries a high mortality risk. In this situation, the intravenous loop-diuretic furosemide induces a rapid reduction in the raised left ventricular filling pressure due to an immediate and substantial increase in systemic venous compliance accompanied by increasing diuresis. This diuretic-induced venodilatation is probably due to the release of prostaglandins. The transient systemic arterial constriction and small increase in systemic blood pressure that follows intravenous furosemide probably results from the release of renin and subsequent activation of angiotensin. These diuretic induced hemodynamic changes are accompanied by restoration of the vasodilator reflex, which enables the heart to accommodate an acute volume load. Orally administered loop diuretics achieve slower, but similar, directional hemodynamic changes. There is no information on hemodynamic or neuroendocrine dose-response effects of loop diuretics, and there is no information pertaining to the use of other diuretic groups in this situation. The hemodynamic changes induced by furosemide summate wi...Continue Reading

Citations

Dec 9, 1976·The New England Journal of Medicine·J S ForresterH J Swan
Apr 1, 1992·Journal of the American College of Cardiology·A R MoosviS Goldstein
Mar 1, 1991·Journal of the American College of Cardiology·L LeeW W O'Neill
Aug 1, 1987·Journal of the American College of Cardiology·M S Verani, R Roberts
May 1, 1987·Journal of the American College of Cardiology·R W JeremyP J Harris
Aug 1, 1986·The American Journal of Cardiology·Z G TuriE Braunwald
May 1, 1984·British Journal of Clinical Pharmacology·I G MackayM L Watson
Aug 11, 1983·The New England Journal of Medicine·Multicenter Postinfarction Research Group
Jan 1, 1981·American Heart Journal·C E RackleyS E Papapietro
Jul 1, 1993·British Heart Journal·K Chatterjee, P Collins

Related Concepts

Vasodilator [EPC]
Pulmonary Edema
Morbidity Aspects
Diuresis
Neurosecretory Systems
Myocardial Infarction
Vasodilator Agents
Renal Insufficiency
AGT
Miosis Disorder

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