Clinical and haemodynamic effects of long-term treatment with torasemide in congestive heart failure

The clinical and haemodynamic effects of 12 weeks of treatment with torasemide, 5 mg/day, were measured in 24 men aged 51-60 years with symptoms of mild, chronic, congestive heart failure. Clinical status was assessed by NYHA functional class and haemodynamic effects were measured at rest and during supine bicycle exercise at the beginning and end of the 12-week period of study. Torasemide was well tolerated and there was no significant change in any of the measured safety variables. Clinical status was improved in 16 of the 23 patients assessed after 12 weeks of treatment and none experienced symptomatic deterioration. Compared with pretreatment haemodynamic measurements, right atrial and pulmonary vascular pressures were significantly decreased both at rest and during exercise after torasemide. Systemic arterial pressure was reduced at rest, but there were no significant changes in cardiac output, heart rate, or systemic and pulmonary vascular resistances either at rest or during exercise, neither were there any significant changes in systemic arterial blood oxygen saturation, pulmonary arterial blood pH, gas tensions, or bicarbonate concentration either at rest or during exercise at 12 weeks. The results of these studies indicate that the clinical and haemodynamic benefits of torasemide are not subject to the development of tolerance during sustained treatment.