Prof. Joan Carles Trullàs and Prof. Luis Beck da Silva, who have both conducted randomized controlled trials on the role of hydrochlorothiazide in decompensated heart failure, discuss when and how to use thiazide diuretics in patients with acute heart failure.
Dr. Joan Carles Trullàs is an Internal Medicine specialist at Hospital de Olot, and he is Professor at University of Vic - Central University of Catalonia.
Dr. Luis Beck da Silva is Cardiologist and Professor of Medicine at the Federal University of Rio Grande do Sul.
The interview was recorded on March 20th, 2023.
Moderators: Prof. Marcus Säemann (Vienna, Austria) and Prof. Dr. Gunnar Heine (both Frankfurt, Germany).
Articles discussed:
Combining loop with thiazide diuretics for decompensated heart failure: the CLOROTIC trial.
Trullàs JC, Morales-Rull JL, Casado J, Carrera-Izquierdo M, Snchez-Marteles M, Conde-Martel A, Dvila-Ramos MF, Llcer P, Salamanca-Bautista P, Prez-Silvestre J, Plasn MN, Cerqueiro JM, Gil P, Formiga F, Manzano L; CLOROTIC trial investigators. Eur Heart J. 2023 doi: 10.1093/eurheartj/ehac689.
Effect of adding hydrochlorothiazide to usual treatment of patients with acute decompensated heart failure: a randomized clinical trial.
Piardi DS, Butzke M, Mazzuca ACM, Gomes BS, Alves SG, Kotzian BJ, Ghisleni EC, Giaretta V, Bellaver P, Varaschin GA, Garbin AP, Beck-da-Silva L.
Sci Rep. 2021 doi: 10.1038/s41598-021-96002-6.
Acetazolamide in Acute Decompensated Heart Failure with Volume Overload.
Mullens W, Dauw J, Martens P, Verbrugge FH, Nijst P, Meekers E, Tartaglia K, Chenot F, Moubayed S, Dierckx R, Blouard P, Troisfontaines P, Derthoo D, Smolders W, Bruckers L, Droogne W, Ter Maaten JM, Damman K, Lassus J, Mebazaa A, Filippatos G, Ruschitzka F, Dupont M; ADVOR Study Group.
N Engl J Med. 2022 doi: 10.1056/NEJMoa2203094.
Aggressive fluid and sodium restriction in acute decompensated heart failure: a randomized clinical trial.
Aliti GB, Rabelo ER, Clausell N, Rohde LE, Biolo A, Beck-da-Silva L. JAMA Intern Med. 2013
doi: 10.1001/jamainternmed.2013.552
Impact of empagliflozin on decongestion in acute heart failure: the EMPULSE trial.
Biegus J, Voors AA, Collins SP, Kosiborod MN, Teerlink JR, Angermann CE, Tromp J, Ferreira JP, Nassif ME, Psotka MA, Brueckmann M, Salsali A, Blatchford JP, Ponikowski P.
Eur Heart J. 2022 doi: 10.1093/eurheartj/ehac530
The SGLT2 inhibitor empagliflozin in patients hospitalized for acute heart failure: a multinational randomized trial.
Voors AA, Angermann CE, Teerlink JR, Collins SP, Kosiborod M, Biegus J, Ferreira JP, Nassif ME, Psotka MA, Tromp J, Borleffs CJW, Ma C, Comin-Colet J, Fu M, Janssens SP, Kiss RG, Mentz RJ, Sakata Y, Schirmer H, Schou M, Schulze PC, Spinarova L, Volterrani M, Wranicz JK, Zeymer U, Zieroth S, Brueckmann M, Blatchford JP, Salsali A, Ponikowski P.
Nat Med. 2022 doi: 10.1038/s41591-021-01659-1
Renin-Angiotensin System Inhibition, Worsening Renal Function, and Outcome in Heart Failure Patients With Reduced and Preserved Ejection Fraction: A Meta-Analysis of Published Study Data.
Beldhuis IE, Streng KW, Ter Maaten JM, Voors AA, van der Meer P, Rossignol P, McMurray JJ, Damman K. Circ Heart Fail. 2017 doi: 10.1161/CIRCHEARTFAILURE.116.003588
Diuretic therapy.
Brater DC. N Engl J Med. 1998 Aug 6;339(6):387-95. doi: 10.1056/NEJM199808063390607
Improvement in Renal Function During the Treatment of Acute Decompensated Heart Failure: Relationship With Markers of Renal Tubular Injury and Prognostic Importance.
Natov PS, Ivey-Miranda JB, Cox ZL, Moreno-Villagomez J, Maulion C, Bellumkonda L, Shlipak MG, Estrella MM, Borlaug BA, Rao VS, Testani JM. Circ Heart Fail. 2023
doi: 10.1161/CIRCHEARTFAILURE.122.009776
Chlorthalidone vs. Hydrochlorothiazide for Hypertension-Cardiovascular Events.
Ishani A, Cushman WC, Leatherman SM, Lew RA, Woods P, Glassman PA, Taylor AA, Hau C, Klint A, Huang GD, Brophy MT, Fiore LD, Ferguson RE; Diuretic Comparison Project Writing Group. N Engl J Med. 2022 doi: 10.1056/NEJMoa2212270
Effects of oral tolvaptan in patients hospitalized for worsening heart failure: the EVEREST Outcome Trial.
Konstam MA, Gheorghiade M, Burnett JC Jr, Grinfeld L, Maggioni AP, Swedberg K, Udelson JE, Zannad F, Cook T, Ouyang J, Zimmer C, Orlandi C; Efficacy of Vasopressin Antagonism in Heart Failure Outcome Study With Tolvaptan (EVEREST) Investigators. JAMA. 2007
doi: 10.1001/jama.297.12.1319
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