Abstract
Background
The pharmacologic modification of the synthesis and deposition of fibrillar collagen
in the myocardium may have effects on the cardiac function, clinical status, and prognosis
of patients with heart failure (HF). Serum procollagen type I carboxyterminal peptide
(PICP) is a biochemical marker of collagen type I fibers synthesis and myocardial
deposition.
Objective
The aim of this study was to evaluate the effects of both the prolonged-release (PR)
formulation of torasemide (torasemide-PR) and furosemide on myocardial fibrosis in
hypertensive patients with chronic HF.
Methods
This was a multicenter, parallel-group, randomized, open-label study with blinded
evaluation of data (PROBE: Prospective Randomized Open-label Blinded End points).
Patients were randomly assigned to treatment with torasemide-PR (n = 77) or furosemide
(n = 78), while receiving the best standard chronic HF treatment. Effects of torasemide-PR
and furosemide on myocardial fibrosis were assessed through PICP serum levels. Twenty-eight
patients discontinued prematurely from the study, 14 in each treatment group.
Results
One hundred fifty-five patients were randomized, 58.1% of whom were male. Mean (SD)
age of the patients was 68.1 (11.4) years in the torasemide-PR group and 69.3 (9.8)
years in the furosemide group. At baseline, 96.1% of patients in the torasemide-PR
group and 89.7% in the furosemide group had NYHA class II HF. Most patients in both
treatment groups presented with preserved ejection fraction (EF >40%). No differences
were found in PICP serum levels at the end of the study between patients treated with
torasemide-PR and patients treated with furosemide (P = 0.75). Adjusted difference (95% CI) for baseline concentration between both treatment
groups was −1.2 (−8.9 to 6.4).
Conclusions
In hypertensive patients with mild and clinically stable HF, long-term administration
of either torasemide-PR or furosemide was not associated with significant effects
on myocardial fibrosis, as assessed by serum PICP. ClinicalTrials.gov identifier: NCT00409942.
Key words
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Article info
Publication history
Published online: September 09, 2011
Accepted:
August 10,
2011
Footnotes
Address correspondence to: Dr. Javier Díez, Área de Ciencias Cardiovasculares, CIMA, Avenida Pío XII 55, 31008 Pamplona, Spain. E-mail: [email protected]
Identification
Copyright
© 2011 Elsevier HS Journals, Inc. Published by Elsevier Inc. All rights reserved.
