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Comparative effectiveness of torasemide versus furosemide in symptomatic therapy in heart failure patients: Preliminary results from the randomized TORNADO trial
Affiliations- I Katedra i Klinika Kardiologii, Poland
- Cardiology Unit, John Paul II Western Hospital, ul. Daleka 11, 05-825 Grodzisk Mazowiecki, Poland
- Department of Anesthesiology and Intensive Care, Medical University of Warsaw, Banacha 1A, 02-677 Warsaw, Poland
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Abstract
Background: Recent reports suggest that torasemide might be more beneficial than furosemide in
patients with symptomatic heart failure (HF). The aim was to compare the effects of torasemide and
furosemide on clinical outcomes in HF patients.
Methods: This study pilot consisted of data from the ongoing multicenter, randomized, unblinded
endpoint phase IV TORNADO (NCT01942109) study. HF patients in New York Heart Association
(NYHA) II–IV class with a stable dose of furosemide were randomized to treatment with equipotential
dose of torasemide (4:1) or continuation of unchanged dose of furosemide. On enrollment and
control visit (3 months after enrollment) clinical examination, 6-minute walk test (6MWT) and
assessment of fluid retention by ZOE Fluid Status Monitor were performed. The primary endpoint was
a composite of improvement of NYHA class, improvement of at least 50 m during 6MWT and decrease
in fluid retention of at least 0.5 W after 3-months follow-up.
Results: The study group included 40 patients (median age 66 years; 77.5% male). During follow-up
7 patients were hospitalized for HF worsening (3 in torasemide and 4 in furosemide-treated patients).
The primary endpoint reached 15 (94%) and 14 (58%) patients on torasemide and furosemide, respectively
(p = 0.03).
Conclusions: In HF patients treated with torasemide fluid overload and symptoms improved more than
in the furosemide group. This positive effect occurred already within 3-month observation.
Abstract
Background: Recent reports suggest that torasemide might be more beneficial than furosemide in
patients with symptomatic heart failure (HF). The aim was to compare the effects of torasemide and
furosemide on clinical outcomes in HF patients.
Methods: This study pilot consisted of data from the ongoing multicenter, randomized, unblinded
endpoint phase IV TORNADO (NCT01942109) study. HF patients in New York Heart Association
(NYHA) II–IV class with a stable dose of furosemide were randomized to treatment with equipotential
dose of torasemide (4:1) or continuation of unchanged dose of furosemide. On enrollment and
control visit (3 months after enrollment) clinical examination, 6-minute walk test (6MWT) and
assessment of fluid retention by ZOE Fluid Status Monitor were performed. The primary endpoint was
a composite of improvement of NYHA class, improvement of at least 50 m during 6MWT and decrease
in fluid retention of at least 0.5 W after 3-months follow-up.
Results: The study group included 40 patients (median age 66 years; 77.5% male). During follow-up
7 patients were hospitalized for HF worsening (3 in torasemide and 4 in furosemide-treated patients).
The primary endpoint reached 15 (94%) and 14 (58%) patients on torasemide and furosemide, respectively
(p = 0.03).
Conclusions: In HF patients treated with torasemide fluid overload and symptoms improved more than
in the furosemide group. This positive effect occurred already within 3-month observation.
Keywords
heart failure, hospitalization, loop diuretics, prognosis, symptoms
About this articleTitle
Comparative effectiveness of torasemide versus furosemide in symptomatic therapy in heart failure patients: Preliminary results from the randomized TORNADO trial
Journal
Issue
Pages
661-668
Published online
2019-12-09
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4197
Article views/downloads
2502
DOI
Pubmed
Bibliographic record
Cardiol J 2019;26(6):661-668.
Keywords
heart failure
hospitalization
loop diuretics
prognosis
symptoms
Authors
Paweł Balsam
Krzysztof Ozierański
Michał Marchel
Monika Gawałko
Łukasz Niedziela
Agata Tymińska
Bartosz Sieradzki
Maciej Sieradzki
Anna Fojt
Elwira Bakuła
Renata Główczyńska
Michał Peller
Maciej Markulis
Janusz Bednarski
Robert Kowalik
Andrzej Cacko
Grzegorz Niewiński
Krzysztof J. Filipiak
Grzegorz Opolski
Marcin Grabowski
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