Diuretics and mineralocorticoid receptor antagonists in the therapy of chronic heart failure with reduced left ventricular ejection fraction

Czech version

Authors: G. Mairgani ¹; F. Málek ²
Authors‘ workplace: Odděleni Interna I, Nemocnice Teplice, Krajská zdravotní, a. s. ¹; Kardiocentrum, Nemocnice Na Homolce, Praha ²
Published in: Kardiol Rev Int Med 2017, 19(1): 51-54

Overview

Diuretics are among the oldest drugs for the therapy of heart failure. The main role of diuretics is to reduce the signs and symptoms of systemic and pulmonary congestion. Loop diuretics are most frequently used for the therapy of heart failure because of their stronger diuretic effect. Some patients require a combination of loop and thiazide diuretics. The diuretic effect of mineralocorticoid receptor antagonists is weak; their role is to block consequences of secondary hyperaldosteronism, which occurs typically in the advanced stages of heart failure. We have evidence that spironolactone and eplerenone reduce mortality and morbidity in heart failure and thus modify the course of the disease.

Keywords:
heart failure – diuretics – mineralocorticoid receptor antagonists

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