{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T20:37:17Z","timestamp":1772138237769,"version":"3.50.1"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2010,7,1]],"date-time":"2010-07-01T00:00:00Z","timestamp":1277942400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2010,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Diuretics, when used to treat congestion in patients with chronic heart failure, improve symptoms and, perhaps, prognosis but little information is available to guide their use in patients with left ventricular systolic dysfunction (LVSD) who are not congested. Chronic diuretic therapy causes persistent and potentially harmful neuroendocrine activation. Alternatively, in patients in whom neuroendocrine activation is blocked with angiotensin-converting enzyme (ACE)-inhibitors and \u03b2-blockers, diuretics may be beneficial by decreasing preload and afterload and preventing congestion. We aimed to assess the effect of the loop diuretic, torasemide on quality of life, and surrogate markers of prognosis when given to patients with LVSD who were not clinically congested and who were optimally treated with ACE-inhibitors (or angiotensin receptor antagonists) and \u03b2-blockers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>Thirty patients with stable LVSD who had no clinically detectable fluid overload were randomized to receive either torasemide 5 mg daily or placebo for 3 months (Phase A), and after a washout phase of 2 months, cross-over was performed for 3 months (Phase B). Diuretic therapy did not cause significant change in peak VO2, mean N-terminal pro-hormone brain natriuretic peptide (NT-proBNP) levels, or measures of quality of life compared with placebo. Diuretic therapy did however lead to significant fall in systolic and diastolic blood pressures and increase in plasma renin levels compared with placebo.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Diuretic therapy with torasemide is not superior to placebo in improving peak VO2 or reducing NT-proBNP levels in patients with left ventricular dysfunction who are not clinically congested.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/eurjhf\/hfq090","type":"journal-article","created":{"date-parts":[[2010,6,4]],"date-time":"2010-06-04T20:26:09Z","timestamp":1275683169000},"page":"746-752","source":"Crossref","is-referenced-by-count":12,"title":["The Effects of Adding Torasemide to Standard Therapy on Peak Oxygen Consumption, Natriuretic Peptides, and Quality of Life in Patients with Compensated Left Ventricular Systolic Dysfunction"],"prefix":"10.1093","volume":"12","author":[{"given":"Sanjay","family":"Gupta","sequence":"first","affiliation":[{"name":"Department of Cardiology, Wythenshawe Hospital , Manchester ,","place":["UK"]},{"name":"Department of Cardiovascular Imaging, Brigham and Womens Hospital , Boston, MA ,","place":["USA"]},{"name":"Department of Cardiology, Castle Hill Hospital , Castle Road, Cottingham, East Yorkshire ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carolyn","family":"Waywell","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Wythenshawe Hospital , Manchester ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nandkumar","family":"Gandhi","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Wythenshawe Hospital , Manchester ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nigel","family":"Clayton","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Wythenshawe Hospital , Manchester ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brian","family":"Keevil","sequence":"additional","affiliation":[{"name":"Department of Biochemical Sciences, Wythenshawe Hospital , Manchester ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew L.","family":"Clark","sequence":"additional","affiliation":[{"name":"Department of Academic Cardiology, Castle Hill Hospital , Cottingham, Hull ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leong L.","family":"Ng","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Sciences, University of Leicester , Leicester ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicholas","family":"Brooks","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Wythenshawe Hospital , Manchester ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ludwig","family":"Neyses","sequence":"additional","affiliation":[{"name":"School of Clinical and Laboratory Sciences, University of Manchester and Manchester Heart Centre, Central Manchester Foundation Trust and University of Manchester , Manchester ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2014,1,13]]},"reference":[{"key":"2026020203334879900_ejhfhfq090-bib-0001","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1136\/hrt.57.1.17","article-title":"Untreated heart failure: clinical and neuroendocrine effects of introducing diuretics","volume":"57","author":"Bayliss","year":"1987","journal-title":"Br Heart 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