[Hemodynamic changes produced by intravenous bumetanide in congestive heart failure]

The hemodynamic variations brought about by the single intravenous infection of 0,5 mg bumetanide have been studied in 7 patients with chronic ischemic heart disease and in 3 patients with non-obstructive hypertrophic cardiomyopathy, all of them in congestive heart failure. The technique employed has been the right heart micro-catheterization. The following parameters have been studied: heart rate, systemic systolic and diastolic pressures, mean pulmonary pressure, end-diastolic pulmonary pressure, total systemic and pulmonary resistances, cardiac index, systolic index, left ventricular systolic work index, timed diuresis, pH, pO2, pCO2, for a four-hours period of observation. Results have been statistically analyzed with the sign test. Bumetanide has brought about a significative reduction of the right pressures and of resistances both in pulmonary and systemic circulations, without any effect on ventricular function indexes. These effects have appeared very early, already within the first 5 m', have remained constant till the end of the experiment and have always preceded the diuretic response. These results allow the view that bumetanide has a double action, initially vascular, then diuretic.