PMID- 26998008 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20201001 IS - 1792-0981 (Print) IS - 1792-1015 (Electronic) IS - 1792-0981 (Linking) VI - 11 IP - 3 DP - 2016 Mar TI - Clinical effects of combined treatment by optimal dose of furosemide and spironolactone on diastolic heart failure in elderly patients. PG - 890-894 AB - Diastolic heart failure (DHF) is characterized by symptoms including reduced ventricular relaxation and compliance, resulting in congestion of pulmonary and systemic circulation. The curative effects of regular cardiac agents are ineffective. Thus, new agents are required to treat chronic cardiac failure. The aim of the present study was to examine the clinical effects of the combined treatment by optimal dose of furosemide (20 mg/day) and spironolactone (40 mg/day) on elderly patients with diastolic heart failure (DHF) [New York Heart Association (NYHA) 1-2 grade]. A total of 93 patients diagnosed with DHF between February, 2013 and February, 2014 were enrolled in the present study. The patients were randomly divided into the furosemide group (20 mg/day, n=27), optimal dose group (20 mg/day furosemide+40 mg/day spirolactone, n=36), and large dose group (40 mg/day furosemide+100 mg/day spirolactone, n=30). Following treatment for one month, a comparison and analysis of the NYHA class, left ventricular ejection fraction (LVEF) and left ventricular end diastolic diameter (LVEDD), left ventricular wall segmental motion among the three groups were performed. The re-hospitalization rate of heart failure and incidence of electrolyte disorder among the three groups was compared and their differences analysed. Compared with pretreatment, the NYHA classifications of the three groups after treatment were reduced and differences were statistically significant (P<0.05). By contrast, for the NYHA classification after treatment there was no statistical significance (P>0.05). Compared with pretreatment, LVEF of the optimal dose group increased, LVEDD decreased, and the average systolic myocardial peak velocity and early diastolic myocardial peak velocity of ventricular wall motion were reduced, with differences being statistically significant (P<0.05). By contrast, in the furosemide and large dose groups no statistical significance was identified before and after the treatment (P>0.05). Improvement of the optimal dose group following treatment was more significant than the remaining two groups, and differences were statistically significant (P<0.05). The re-hospitalization rate of heart failure and incidence of electrolyte disorder in the optimal dose group following treatment were significantly less than the other two groups, and differences were statistically significant (P<0.05). In conclusion, the optimal dose (20 mg/day furosemide+40 mg/day spirolactone) significantly improved the clinical symptoms of elderly DHF patients (NYHA 1-2 grade) and ameliorated their long-term prognosis. FAU - Chen, Zhi-Hao AU - Chen ZH AD - Department of Cardiology, The First College of Clinical Medical Sciences, China Three Gorges University, Yichang, Hubei 443000, P.R. China; Institute of Cardiovascular Diseases, China Three Gorges University, Yichang, Hubei 443000, P.R. China. FAU - Jiang, Yu-Rong AU - Jiang YR AD - Department of Cardiology, The First College of Clinical Medical Sciences, China Three Gorges University, Yichang, Hubei 443000, P.R. China; Institute of Cardiovascular Diseases, China Three Gorges University, Yichang, Hubei 443000, P.R. China. FAU - Peng, Jia-Qin AU - Peng JQ AD - Department of Cardiology, The First College of Clinical Medical Sciences, China Three Gorges University, Yichang, Hubei 443000, P.R. China; Institute of Cardiovascular Diseases, China Three Gorges University, Yichang, Hubei 443000, P.R. China. FAU - Ding, Jia-Wang AU - Ding JW AD - Department of Cardiology, The First College of Clinical Medical Sciences, China Three Gorges University, Yichang, Hubei 443000, P.R. China; Institute of Cardiovascular Diseases, China Three Gorges University, Yichang, Hubei 443000, P.R. China. FAU - Li, Song AU - Li S AD - Department of Cardiology, The First College of Clinical Medical Sciences, China Three Gorges University, Yichang, Hubei 443000, P.R. China; Institute of Cardiovascular Diseases, China Three Gorges University, Yichang, Hubei 443000, P.R. China. FAU - Yang, Jian AU - Yang J AD - Department of Cardiology, The First College of Clinical Medical Sciences, China Three Gorges University, Yichang, Hubei 443000, P.R. China; Institute of Cardiovascular Diseases, China Three Gorges University, Yichang, Hubei 443000, P.R. China. FAU - Wu, Hui AU - Wu H AD - Department of Cardiology, The First College of Clinical Medical Sciences, China Three Gorges University, Yichang, Hubei 443000, P.R. China; Institute of Cardiovascular Diseases, China Three Gorges University, Yichang, Hubei 443000, P.R. China. FAU - Yang, Jun AU - Yang J AD - Department of Cardiology, The First College of Clinical Medical Sciences, China Three Gorges University, Yichang, Hubei 443000, P.R. China; Institute of Cardiovascular Diseases, China Three Gorges University, Yichang, Hubei 443000, P.R. China. LA - eng PT - Journal Article DEP - 20151231 PL - Greece TA - Exp Ther Med JT - Experimental and therapeutic medicine JID - 101531947 PMC - PMC4774326 OTO - NOTNLM OT - diastolic heart failure OT - elderly OT - electrolyte OT - furosemide OT - left ventricular ejection fraction OT - left ventricular end diastolic diameter OT - spironolactone EDAT- 2016/03/22 06:00 MHDA- 2016/03/22 06:01 PMCR- 2015/12/31 CRDT- 2016/03/22 06:00 PHST- 2015/11/20 00:00 [received] PHST- 2015/12/30 00:00 [accepted] PHST- 2016/03/22 06:00 [entrez] PHST- 2016/03/22 06:00 [pubmed] PHST- 2016/03/22 06:01 [medline] PHST- 2015/12/31 00:00 [pmc-release] AID - ETM-0-0-2967 [pii] AID - 10.3892/etm.2015.2967 [doi] PST - ppublish SO - Exp Ther Med. 2016 Mar;11(3):890-894. doi: 10.3892/etm.2015.2967. Epub 2015 Dec 31.