Impact of Torsemide on Cardiac Remodeling and Renin-Angiotensin-Aldosterone System in Heart Failure Patients

Abraham, Bishoy; Megaly, Michael; Sous, Mina; Louka, Boshra; Fraser, Robert; Szpunar, Susan; Goldsmith, Steven R.; Simegn, Mengistu; Bart, Bradley A.; Azzo, Zain; Mesiha, Nancy

doi:10.1016/s0735-1097(20)31387-5

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“…Among the loop diuretics, torsemide has distinct pharmacological properties, including predictable oral bioavailability (80%-100%), a pre-dominant hepatic metabolism, absorption that is not affected by food, a relatively long half-life (3-6 hours), and a quick onset of action. Additionally, torsemide can slow or reverse the development of myocardial fibrosis and attenuate progressive ventricular dilation and hypertrophy [9][10][11][12][13]. While loop diuretics can help manage symptoms of fluid overload, their role in preventing or treating cardiac remodeling in HF is not very clear.…”

Section: Introductionmentioning

confidence: 99%

The Potential Role of Torsemide in Optimizing Loop Diuretic Therapy for Heart Failure Patients

Chopra¹,

Mohanan²,

Kher³

et al. 2023

Cureus

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Heart failure is associated with an increased frequency of hospitalization, reduced life span, and greater risk to public health, thus posing a challenge. In India, torsemide is one of the commonly used loop diuretics for decongestion in heart failure. However, this use of torsemide, including its dosing, and up/down titration, is based on practical experience. Loop diuretic therapy for heart failure patients poses several dilemmas due to the lack of robust evidence based on which treatment decisions can be made. To guide physicians on the optimal use of torsemide in heart failure patients with or without renal impairment, a panel of expert cardiologists and nephrologists from India convened to develop this expert opinion document for the use of torsemide. This expert opinion on torsemide will pave the way for optimal management with loop diuretic therapy in real-world heart failure patients.

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