Congestive heart failure diuretics: Difference between revisions

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{{Congestive heart failure}}
{{Congestive heart failure}}
{{CMG}}; {{AOEIC}} {{LG}}
{{CMG}}; {{AOEIC}} {{LG}} {{EdzelCo}}


==Overview==
==Overview==
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* [[Eplerenone]] is more specific for [[aldosterone blockade]] and, therefore, causes less [[gynaecomastia]].
* [[Eplerenone]] is more specific for [[aldosterone blockade]] and, therefore, causes less [[gynaecomastia]].
*In [[patients]] with impaired [[renal function]] and in those with serum [[potassium]] concentrations >5.0 mmol/L, [[MRA]] should be used with causion.
*In [[patients]] with impaired [[renal function]] and in those with serum [[potassium]] concentrations >5.0 mmol/L, [[MRA]] should be used with causion.
== 2022 AHA/ACC/HFSA Heart Failure Guideline (DO NOT EDIT) <ref name="pmid35363500">{{cite journal| author=Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM | display-authors=etal| title=2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. | journal=Circulation | year= 2022 | volume= 145 | issue= 18 | pages= e876-e894 | pmid=35363500 | doi=10.1161/CIR.0000000000001062 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=35363500  }} </ref>==
===[[Diuretics]] and [[Decongestion]] Strategies in [[Patients]] with [[HF]] (DO NOT EDIT)<ref name="pmid35363500">{{cite journal| author=Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM | display-authors=etal| title=2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. | journal=Circulation | year= 2022 | volume= 145 | issue= 18 | pages= e876-e894 | pmid=35363500 | doi=10.1161/CIR.0000000000001062 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=35363500  }} </ref><ref name="pmid23747642">{{cite journal| author=Yancy CW, Jessup M, Bozkurt B, Masoudi FA, Butler J, McBride PE et al.| title=2013 ACCF/AHA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. | journal=J Am Coll Cardiol | year= 2013 | volume=  | issue=  | pages=  | pmid=23747642 | doi=10.1016/j.jacc.2013.05.019 | pmc= |url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23747642  }} </ref><ref name="pmid19324967">Jessup M, Abraham WT, Casey DE, Feldman AM, Francis GS, Ganiats TG et al. (2009) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=19324967 2009 focused update: ACCF/AHA Guidelines for the Diagnosis and Management of Heart Failure in Adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: developed in collaboration with the International Society for Heart and Lung Transplantation.] ''Circulation'' 119 (14):1977-2016. [http://dx.doi.org/10.1161/CIRCULATIONAHA.109.192064 DOI:10.1161/CIRCULATIONAHA.109.192064] PMID:[http://pubmed.gov/19324967 19324967]</ref>===
{|class="wikitable" style="width:80%"
|-
| colspan="1" style="text-align:center; background:LightGreen"| [[ACC AHA guidelines classification scheme#Classification of Recommendations|Class I]]
|-
|bgcolor="LightGreen"|<nowiki>"</nowiki>'''1.''' In [[patients]] with [[HF]] who have fluid retention, [[diuretics]] are recommended to relieve [[congestion]], improve [[symptoms]], and prevent worsening [[HF]]. <ref name="pmid7997385">{{cite journal| author=Patterson JH, Adams KF, Applefeld MM, Corder CN, Masse BR| title=Oral torsemide in patients with chronic congestive heart failure: effects on body weight, edema, and electrolyte excretion. Torsemide Investigators Group. | journal=Pharmacotherapy | year= 1994 | volume= 14 | issue= 5 | pages= 514-21 | pmid=7997385 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7997385  }} </ref><ref name="pmid8111802">{{cite journal| author=Goebel KM| title=Six-week study of torsemide in patients with congestive heart failure. | journal=Clin Ther | year= 1993 | volume= 15 | issue= 6 | pages= 1051-9 | pmid=8111802 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8111802  }} </ref><ref name="pmid7468610">{{cite journal| author=Wilson JR, Reichek N, Dunkman WB, Goldberg S| title=Effect of diuresis on the performance of the failing left ventricle in man. | journal=Am J Med | year= 1981 | volume= 70 | issue= 2 | pages= 234-9 | pmid=7468610 | doi=10.1016/0002-9343(81)90755-5 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7468610  }} </ref><ref name="pmid8225657">{{cite journal| author=Parker JO| title=The effects of oral ibopamine in patients with mild heart failure--a double blind placebo controlled comparison to furosemide. The Ibopamine Study Group. | journal=Int J Cardiol | year= 1993 | volume= 40 | issue= 3 | pages= 221-7 | pmid=8225657 | doi=10.1016/0167-5273(93)90004-z | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8225657  }} </ref><ref name="pmid2888942">{{cite journal| author=Richardson A, Bayliss J, Scriven AJ, Parameshwar J, Poole-Wilson PA, Sutton GC| title=Double-blind comparison of captopril alone against frusemide plus amiloride in mild heart failure. | journal=Lancet | year= 1987 | volume= 2 | issue= 8561 | pages= 709-11 | pmid=2888942 | doi=10.1016/s0140-6736(87)91074-9 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2888942  }} </ref>  ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B-NR]])'' <nowiki>"</nowiki>
|-
|bgcolor="LightGreen"|<nowiki>"</nowiki>'''2.''' For [[patients]] with [[HF]] and [[congestive symptoms]], addition of a [[thiazide]] (eg, [[metolazone]]) to [[treatment]] with a [[loop diuretic]] should be reserved for [[patients]] who do not respond to moderate or high-dose [[loop diuretics]] to minimize [[electrolyte]] abnormalities. <ref name="pmid26209004">{{cite journal| author=Grodin JL, Stevens SR, de Las Fuentes L, Kiernan M, Birati EY, Gupta D | display-authors=etal| title=Intensification of Medication Therapy for Cardiorenal Syndrome in Acute Decompensated Heart Failure. | journal=J Card Fail | year= 2016 | volume= 22 | issue= 1 | pages= 26-32 | pmid=26209004 | doi=10.1016/j.cardfail.2015.07.007 | pmc=4706474 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26209004  }} </ref>  ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B-NR]])'' <nowiki>"</nowiki>
|}
=====Mineralocorticoid Receptor Antagonists (MRAs)=====
{|class="wikitable" style="width:80%"
|-
| colspan="1" style="text-align:center; background:LightGreen"| [[ACC AHA guidelines classification scheme#Classification of Recommendations|Class I]]
|-
|bgcolor="LightGreen"|<nowiki>"</nowiki>'''1.''' In [[patients]] with [[HFrEF]] and [[NYHA]] class II to IV [[symptoms]], an [[MRA]] ([[spironolactone]] or [[epleronone]]) is recommended to reduce [[morbidity]] and [[mortality]], if [[eGFR]] is >30 mL/min/1.73 m<sup>2</sup> and [[serum]] [[potassium]] is <5.0 mEq/L. Careful monitoring of [[potassium]], [[renal function]], and [[diuretic]] dosing should be performed at initiation and closely monitored thereafter to minimize risk of [[hyperkalemia]] and [[renal insufficiency]]. <ref name="pmid10471456">{{cite journal| author=Pitt B, Zannad F, Remme WJ, Cody R, Castaigne A, Perez A | display-authors=etal| title=The effect of spironolactone on morbidity and mortality in patients with severe heart failure. Randomized Aldactone Evaluation Study Investigators. | journal=N Engl J Med | year= 1999 | volume= 341 | issue= 10 | pages= 709-17 | pmid=10471456 | doi=10.1056/NEJM199909023411001 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10471456  }} </ref><ref name="pmid12668699">{{cite journal| author=Pitt B, Remme W, Zannad F, Neaton J, Martinez F, Roniker B | display-authors=etal| title=Eplerenone, a selective aldosterone blocker, in patients with left ventricular dysfunction after myocardial infarction. | journal=N Engl J Med | year= 2003 | volume= 348 | issue= 14 | pages= 1309-21 | pmid=12668699 | doi=10.1056/NEJMoa030207 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12668699  }}  [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=&cmd=prlinks&id=12899810 Review in: J Fam Pract. 2003 Aug;52(8):598-9]  [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=&cmd=prlinks&id=12954024 Review in: ACP J Club. 2003 Sep-Oct;139(2):32] </ref><ref name="pmid21073363">{{cite journal| author=Zannad F, McMurray JJ, Krum H, van Veldhuisen DJ, Swedberg K, Shi H | display-authors=etal| title=Eplerenone in patients with systolic heart failure and mild symptoms. | journal=N Engl J Med | year= 2011 | volume= 364 | issue= 1 | pages= 11-21 | pmid=21073363 | doi=10.1056/NEJMoa1009492 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21073363  }}  [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=&cmd=prlinks&id=21558564 Review in: Evid Based Med. 2011 Aug;16(4):121-2]  [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=&cmd=prlinks&id=21814643 Review in: J Fam Pract. 2011 Aug;60(8):482-4] </ref> ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: A]])'' <nowiki>"</nowiki>
|}
{|class="wikitable" style="width:80%"
|-
| colspan="1" style="text-align:center; background:White"| [[ACC AHA guidelines classification scheme#Classification of Recommendations|Value Statement: High Value]]
|-
|bgcolor="White"|<nowiki>"</nowiki>'''2.''' In [[patients]] with [[HFrEF]] and [[NYHA]] II to IV [[symptoms]], [[MRA]] [[therapy]] provides high economic value.<ref name="pmid23433562">{{cite journal| author=Banka G, Heidenreich PA, Fonarow GC| title=Incremental cost-effectiveness of guideline-directed medical therapies for heart failure. | journal=J Am Coll Cardiol | year= 2013 | volume= 61 | issue= 13 | pages= 1440-6 | pmid=23433562 | doi=10.1016/j.jacc.2012.12.022 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23433562  }} </ref><ref name="pmid12085979">{{cite journal| author=Glick HA, Orzol SM, Tooley JF, Remme WJ, Sasayama S, Pitt B| title=Economic evaluation of the randomized aldactone evaluation study (RALES): treatment of patients with severe heart failure. | journal=Cardiovasc Drugs Ther | year= 2002 | volume= 16 | issue= 1 | pages= 53-9 | pmid=12085979 | doi=10.1023/a:1015371616135 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12085979  }} </ref><ref name="pmid15723981">{{cite journal| author=Weintraub WS, Zhang Z, Mahoney EM, Kolm P, Spertus JA, Caro J | display-authors=etal| title=Cost-effectiveness of eplerenone compared with placebo in patients with myocardial infarction complicated by left ventricular dysfunction and heart failure. | journal=Circulation | year= 2005 | volume= 111 | issue= 9 | pages= 1106-13 | pmid=15723981 | doi=10.1161/01.CIR.0000157146.86758.BC | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15723981  }} </ref><ref name="pmid20104935">{{cite journal| author=Zhang Z, Mahoney EM, Kolm P, Spertus J, Caro J, Willke R | display-authors=etal| title=Cost effectiveness of eplerenone in patients with heart failure after acute myocardial infarction who were taking both ACE inhibitors and beta-blockers: subanalysis of the EPHESUS. | journal=Am J Cardiovasc Drugs | year= 2010 | volume= 10 | issue= 1 | pages= 55-63 | pmid=20104935 | doi=10.2165/11319940-000000000-00000 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20104935  }} </ref>  ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: A]])'' <nowiki>"</nowiki>
|}
{|class="wikitable" style="width:80%"
|-
| colspan="1" style="text-align:center; background:LightCoral"| [[ACC AHA guidelines classification scheme#Classification of Recommendations|Class III]] (Harm)
|-
|bgcolor="LightCoral"|<nowiki>"</nowiki>'''3.''' In [[patients]] taking [[MRA]] whose [[serum]] [[potassium]] cannot be maintained at <5.5 mEq/L, [[MRA]] should be discontinued to avoid life-threatening [[hyperkalemia]]. <ref name="pmid23188026">{{cite journal| author=Hernandez AF, Mi X, Hammill BG, Hammill SC, Heidenreich PA, Masoudi FA | display-authors=etal| title=Associations between aldosterone antagonist therapy and risks of mortality and readmission among patients with heart failure and reduced ejection fraction. | journal=JAMA | year= 2012 | volume= 308 | issue= 20 | pages= 2097-107 | pmid=23188026 | doi=10.1001/jama.2012.14795 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23188026  }} </ref><ref name="pmid15295047">{{cite journal| author=Juurlink DN, Mamdani MM, Lee DS, Kopp A, Austin PC, Laupacis A | display-authors=etal| title=Rates of hyperkalemia after publication of the Randomized Aldactone Evaluation Study. | journal=N Engl J Med | year= 2004 | volume= 351 | issue= 6 | pages= 543-51 | pmid=15295047 | doi=10.1056/NEJMoa040135 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15295047  }} </ref> ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B-NR]])'' <nowiki>"</nowiki>
|}
==External Link==
*[https://www.ahajournals.org/doi/epub/10.1161/CIR.0000000000001063.full.pdf 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines]<ref name="pmid35363499">{{cite journal |vauthors=Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM, Deswal A, Drazner MH, Dunlay SM, Evers LR, Fang JC, Fedson SE, Fonarow GC, Hayek SS, Hernandez AF, Khazanie P, Kittleson MM, Lee CS, Link MS, Milano CA, Nnacheta LC, Sandhu AT, Stevenson LW, Vardeny O, Vest AR, Yancy CW |title=2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines |journal=Circulation |volume=145 |issue=18 |pages=e895–e1032 |date=May 2022 |pmid=35363499 |doi=10.1161/CIR.0000000000001063 |url=}} </ref>


==References==
==References==

Latest revision as of 15:22, 28 November 2022



Resident
Survival
Guide
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Congestive Heart Failure Microchapters

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Acute Pharmacotherapy
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Implantation of Intracardiac Defibrillator
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ACC/AHA Guideline Recommendations

Initial and Serial Evaluation of the HF Patient
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Patients With a Prior MI
Sudden Cardiac Death Prevention
Surgical/Percutaneous/Transcather Interventional Treatments of HF
Patients at high risk for developing heart failure (Stage A)
Patients with cardiac structural abnormalities or remodeling who have not developed heart failure symptoms (Stage B)
Patients with current or prior symptoms of heart failure (Stage C)
Patients with refractory end-stage heart failure (Stage D)
Coordinating Care for Patients With Chronic HF
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Implementation of Practice Guidelines

Congestive heart failure end-of-life considerations

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Obstructive Sleep Apnea in the Patient with CHF
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Congestive heart failure diuretics On the Web

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Risk calculators and risk factors for Congestive heart failure diuretics

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Lakshmi Gopalakrishnan, M.B.B.S. [2] Edzel Lorraine Co, DMD, MD[3]

Overview

Diuretics reduce circulating volume, improve symptoms and are a mainstay of therapy for congestive heart failure. While these agents improve symptoms, they have not been associated with a reduction in mortality and are associated with electrolyte imbalances.

Diuretics

Diuretics


MRA or Mineralocorticoid receptor antagonists

2022 AHA/ACC/HFSA Heart Failure Guideline (DO NOT EDIT) [5]

Diuretics and Decongestion Strategies in Patients with HF (DO NOT EDIT)[5][6][7]

Class I
"1. In patients with HF who have fluid retention, diuretics are recommended to relieve congestion, improve symptoms, and prevent worsening HF. [8][9][10][11][12] (Level of Evidence: B-NR) "
"2. For patients with HF and congestive symptoms, addition of a thiazide (eg, metolazone) to treatment with a loop diuretic should be reserved for patients who do not respond to moderate or high-dose loop diuretics to minimize electrolyte abnormalities. [13] (Level of Evidence: B-NR) "


Mineralocorticoid Receptor Antagonists (MRAs)
Class I
"1. In patients with HFrEF and NYHA class II to IV symptoms, an MRA (spironolactone or epleronone) is recommended to reduce morbidity and mortality, if eGFR is >30 mL/min/1.73 m2 and serum potassium is <5.0 mEq/L. Careful monitoring of potassium, renal function, and diuretic dosing should be performed at initiation and closely monitored thereafter to minimize risk of hyperkalemia and renal insufficiency. [4][14][15] (Level of Evidence: A) "
Value Statement: High Value
"2. In patients with HFrEF and NYHA II to IV symptoms, MRA therapy provides high economic value.[16][17][18][19] (Level of Evidence: A) "
Class III (Harm)
"3. In patients taking MRA whose serum potassium cannot be maintained at <5.5 mEq/L, MRA should be discontinued to avoid life-threatening hyperkalemia. [20][21] (Level of Evidence: B-NR) "

External Link

References

  1. Mullens W, Damman K, Harjola VP, Mebazaa A, Brunner-La Rocca HP, Martens P, Testani JM, Tang W, Orso F, Rossignol P, Metra M, Filippatos G, Seferovic PM, Ruschitzka F, Coats AJ (February 2019). "The use of diuretics in heart failure with congestion - a position statement from the Heart Failure Association of the European Society of Cardiology". Eur J Heart Fail. 21 (2): 137–155. doi:10.1002/ejhf.1369. PMID 30600580. Vancouver style error: initials (help)
  2. Faris R, Flather M, Purcell H, Henein M, Poole-Wilson P, Coats A (February 2002). "Current evidence supporting the role of diuretics in heart failure: a meta analysis of randomised controlled trials". Int J Cardiol. 82 (2): 149–58. doi:10.1016/s0167-5273(01)00600-3. PMID 11853901.
  3. Rohde LE, Rover MM, Figueiredo Neto JA, Danzmann LC, Bertoldi EG, Simões MV, Silvestre OM, Ribeiro A, Moura LZ, Beck-da-Silva L, Prado D, Sant'Anna RT, Bridi LH, Zimerman A, Raupp da Rosa P, Biolo A (November 2019). "Short-term diuretic withdrawal in stable outpatients with mild heart failure and no fluid retention receiving optimal therapy: a double-blind, multicentre, randomized trial". Eur Heart J. 40 (44): 3605–3612. doi:10.1093/eurheartj/ehz554. PMID 31424503. Vancouver style error: initials (help)
  4. 4.0 4.1 Pitt B, Zannad F, Remme WJ, Cody R, Castaigne A, Perez A, Palensky J, Wittes J (September 1999). "The effect of spironolactone on morbidity and mortality in patients with severe heart failure. Randomized Aldactone Evaluation Study Investigators". N Engl J Med. 341 (10): 709–17. doi:10.1056/NEJM199909023411001. PMID 10471456.
  5. 5.0 5.1 Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM; et al. (2022). "2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines". Circulation. 145 (18): e876–e894. doi:10.1161/CIR.0000000000001062. PMID 35363500 Check |pmid= value (help).
  6. Yancy CW, Jessup M, Bozkurt B, Masoudi FA, Butler J, McBride PE; et al. (2013). "2013 ACCF/AHA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines". J Am Coll Cardiol. doi:10.1016/j.jacc.2013.05.019. PMID 23747642.
  7. Jessup M, Abraham WT, Casey DE, Feldman AM, Francis GS, Ganiats TG et al. (2009) 2009 focused update: ACCF/AHA Guidelines for the Diagnosis and Management of Heart Failure in Adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: developed in collaboration with the International Society for Heart and Lung Transplantation. Circulation 119 (14):1977-2016. DOI:10.1161/CIRCULATIONAHA.109.192064 PMID:19324967
  8. Patterson JH, Adams KF, Applefeld MM, Corder CN, Masse BR (1994). "Oral torsemide in patients with chronic congestive heart failure: effects on body weight, edema, and electrolyte excretion. Torsemide Investigators Group". Pharmacotherapy. 14 (5): 514–21. PMID 7997385.
  9. Goebel KM (1993). "Six-week study of torsemide in patients with congestive heart failure". Clin Ther. 15 (6): 1051–9. PMID 8111802.
  10. Wilson JR, Reichek N, Dunkman WB, Goldberg S (1981). "Effect of diuresis on the performance of the failing left ventricle in man". Am J Med. 70 (2): 234–9. doi:10.1016/0002-9343(81)90755-5. PMID 7468610.
  11. Parker JO (1993). "The effects of oral ibopamine in patients with mild heart failure--a double blind placebo controlled comparison to furosemide. The Ibopamine Study Group". Int J Cardiol. 40 (3): 221–7. doi:10.1016/0167-5273(93)90004-z. PMID 8225657.
  12. Richardson A, Bayliss J, Scriven AJ, Parameshwar J, Poole-Wilson PA, Sutton GC (1987). "Double-blind comparison of captopril alone against frusemide plus amiloride in mild heart failure". Lancet. 2 (8561): 709–11. doi:10.1016/s0140-6736(87)91074-9. PMID 2888942.
  13. Grodin JL, Stevens SR, de Las Fuentes L, Kiernan M, Birati EY, Gupta D; et al. (2016). "Intensification of Medication Therapy for Cardiorenal Syndrome in Acute Decompensated Heart Failure". J Card Fail. 22 (1): 26–32. doi:10.1016/j.cardfail.2015.07.007. PMC 4706474. PMID 26209004.
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