Comparative effectiveness of torasemide versus furosemide in symptomatic therapy in heart failure patients: Preliminary results from the randomized TORNADO trial

Background: Recent reports suggest that torasemide might be more beneficial than furosemide inpatients with symptomatic heart failure (HF). The aim was to compare the effects of torasemide andfurosemide on clinical outcomes in HF patients.Methods: This study pilot consisted of data from the ongoing multicenter, randomized, unblindedendpoint 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 equipotentialdose of torasemide (4:1) or continuation of unchanged dose of furosemide. On enrollment andcontrol visit (3 months after enrollment) clinical examination, 6-minute walk test (6MWT) andassessment of fluid retention by ZOE Fluid Status Monitor were performed. The primary endpoint wasa composite of improvement of NYHA class, improvement of at least 50 m during 6MWT and decreasein 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-up7 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 thanin the furosemide group. This positive effect occurred already within 3-month observation

Additional file 1: of The impact of torasemide on haemodynamic and neurohormonal stress, and cardiac remodelling in heart failure – TORNADO: a study protocol for a randomized controlled trial

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