{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,21]],"date-time":"2025-08-21T16:53:13Z","timestamp":1755795193047,"version":"3.44.0"},"reference-count":32,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Open Heart"],"accepted":{"date-parts":[[2015,7,31]]},"published-print":{"date-parts":[[2016,2]]},"abstract":"<jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>Short-acting loop diuretics are known to enhance cardiac sympathetic nerve activity (CSNA) in patients with chronic heart failure (CHF). The effects of two loop diuretics\u2014long-acting azosemide and short-acting furosemide\u2014on CSNA were evaluated using <jats:sup>123<\/jats:sup>I-metaiodobenzylguanidine (MIBG) scintigraphy in patients with CHF.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>The present study was a subanalysis of our previously published study, which had reported that serial <jats:sup>123<\/jats:sup>I-MIBG studies were the most useful prognostic indicator in patients with CHF. Patients with CHF (n=208, left ventricular ejection fraction &lt;45%) but no history of cardiac events for at least 5\u2005months prior to the study were identified according to their histories of acute decompensated heart failure requiring hospitalisation. Patients underwent <jats:sup>123<\/jats:sup>I-MIBG scintigraphy immediately before hospital discharge and at a 6-month follow-up. The delayed % denervation, delayed heart\/mediastinum count (H\/M) ratio and washout rate (WR) were determined using <jats:sup>123<\/jats:sup>I-MIBG scintigraphy. A total of 108 patients were selected, and propensity score matching was used to compare patients treated with either oral azosemide (n=54) or furosemide (n=54).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>After treatment, <jats:sup>123<\/jats:sup>I-MIBG scintigraphic parameters improved in both groups. However, the degree of change in % denervation was \u221213.8\u00b110.5 in the azosemide group and \u22125.7\u00b112.7 in the furosemide group (p&lt;0.01), the change in H\/M ratio was 0.20\u00b10.16 in the azosemide group and 0.06\u00b10.19 in the furosemide group (p&lt;0.01), and the change in WR was \u221211.3\u00b19.2% in the azosemide group and \u22123.0\u00b112.7% in the furosemide group (p&lt;0.01). Moreover, multivariate analysis showed an independent and significant positive relationship between furosemide and \u03b4-WR from hospital discharge to 6\u2005months after treatment in patients with CHF (p=0.001).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>These findings indicate that azosemide suppresses CSNA compared with furosemide in patients with CHF.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Trial registration number<\/jats:title>\n                  <jats:p>UMIN000000626 (UMIN-CTR Clinical Trial).<\/jats:p>\n               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