{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T06:42:58Z","timestamp":1790664178669,"version":"4.1.0"},"reference-count":42,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2017,9,11]],"date-time":"2017-09-11T00:00:00Z","timestamp":1505088000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Framework Programme 7 of the European Commission","award":["FP7-HEALTH-2010-261409"],"award-info":[{"award-number":["FP7-HEALTH-2010-261409"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,3,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>Heart failure with preserved ejection fraction (HFpEF) is associated with myocardial remodelling including severe pro-fibrotic changes contributing to an increase in left ventricular stiffness and diastolic dysfunction. Serum C-terminal propeptide of procollagen type I (PIP) strongly correlates with the turnover of extracellular cardiac matrix proteins and fibrosis. Torasemide, but not furosemide, was described to reduce collagen type I synthesis in clinically unstable patients with heart failure with reduced ejection fraction. We evaluated whether its effect translated to HFpEF patients with type 2 diabetes mellitus (T2DM) and abnormal basal PIP levels.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>We performed a relatively small, single-centre, randomised, double-blind, two-arm parallel-group, active controlled clinical trial in 35 HFpEF patients with T2DM to determine the effects of a 9-month treatment with torasemide vs. furosemide on changes of serum PIP levels. Patients with increased PIP levels (\u2265110 ng\/mL), or evidence of structural changes with a left atrial volume index (LAVI) &amp;gt;29 mL\/m2 and abnormal PIP levels (\u226570 ng\/mL), were eligible to participate. Fifteen patients were female (42%), mean age was 69 years, body mass index was 34.7 kg\/m2, 83% were in New York Heart Association class II\/III. Echocardiographic characteristics showed a mean left ventricular ejection fraction of &amp;gt;60%, a left ventricular mass index &amp;gt;120 g\/m2, an E\/e' ratio of 14, and a LAVI of 40 mL\/m2 with a NT-proBNP of 174 ng\/L and a 6-minute walk distance of 421 m. Mean per cent change in PIP was 2.63 \u00b1 5.68% (\u00b1SEM) in torasemide vs. 2.74 \u00b1 6.49% in furosemide (P = 0.9898) treated patients. Torasemide was not superior to furosemide in improving functional capacity, diastolic function, quality of life, or neuroendocrine activation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this hypothesis-generating, mechanistic trial in stable HFpEF patients with T2DM, neither long-term administration of torasemide nor furosemide was associated with a significant effect on myocardial fibrosis, as assessed by serum PIP. Further studies are urgently needed in this field. More specific diuretic and anti-fibrotic treatment strategies in T2DM and\/or HFpEF are warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ejhf.960","type":"journal-article","created":{"date-parts":[[2017,9,11]],"date-time":"2017-09-11T01:26:39Z","timestamp":1505093199000},"page":"460-470","source":"Crossref","is-referenced-by-count":46,"title":["Investigating a Biomarker-Driven Approach to Target Collagen Turnover in Diabetic Heart Failure with Preserved Ejection Fraction Patients. Effect of Torasemide Versus Furosemide on Serum C-Terminal Propeptide of Procollagen Type I (DROP-PIP trial)"],"prefix":"10.1093","volume":"20","author":[{"given":"Tobias Daniel","family":"Trippel","sequence":"first","affiliation":[{"name":"Department of Medicine and Cardiology (CVK), Charit\u00e9 - Universit\u00e4tsmedizin Berlin , Berlin ,","place":["Germany"]},{"name":"German Centre for Cardiovascular Research (DZHK), Partner Site Berlin , Berlin ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie","family":"Van Linthout","sequence":"additional","affiliation":[{"name":"Department of Medicine and Cardiology (CVK), Charit\u00e9 - Universit\u00e4tsmedizin Berlin , Berlin ,","place":["Germany"]},{"name":"German Centre for Cardiovascular Research (DZHK), Partner Site Berlin , Berlin ,","place":["Germany"]},{"name":"Berlin-Brandenburg Centre for Regenerative Therapies , Berlin 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