DIURETICS IN THE TREATMENT OF CHRONIC HEART FAILURE: FUROSEMIDE OR TORASEMIDE (LITERATURE REVIEW)

Abstract

Optimization of diuretic therapy in patients with chronic heart failure (CHF) is a complex problem with many unsolved questions. Diuretics play an important role in the treatment of heart failure. Current guidelines recommend using loop diuretics for the treatment of CHF patients with fluid overload. Torasemide and furosemide are representatives of loop diuretics with an identical diuretic mechanism, but different pharmacokinetic properties. Due to greater bioavailability, a higher degree of connection with proteins and a longer half-life, torasemide acts faster, less often causes accelerated urination than furosemide, is well absorbed from the gastrointestinal tract even with hyperhydration caused by diseases of the heart, kidneys and liver. Torasemide inhibits the increased activity of the renin-angiotensin-aldosterone system, which is characteristic of CHF, without affecting the level of electrolytes in the blood. In addition, torasemide slows down the development of myocardial fibrosis and promotes reverse remodeling of the ventricles. Compared to furosemide, torasemide improves the quality of life of patients with CHF, reduces the frequency of hospitalizations, the length of stay in the hospital, and improves exercise tolerance. In recent years, there have been calls for a transition to the active clinical use of torasemide instead of furosemide in CHF patients.Objective: to systematize modern literature data on the role of loop diuretics furosemide and torasemide in the treatment of chronic heart failure.Conclusion. The loop diuretic torasemide has an advantage over furosemide in the treatment of chronic heart failure.