Cor Vasa 2026, 68(2):196-200 | DOI: 10.33678/cor.2025.103

(The Current Role of Diuretic Therapy in the Treatment of Heart Failure)

Jan Mikula
Kardiologická klinika, 2. lékařská fakulta Univerzity Karlovy a Fakultní nemocnice Motol a Homolka, Praha, Česká republika

Diuretic therapy, particularly with loop diuretics, represents a cornerstone of pharmacological management in patients with symptomatic heart failure. This review article summarizes the effects of diuretic therapy on the cardiovascular system, outlines current clinical recommendations, and discusses the available evidence supporting the use of loop diuretics in both acute and chronic heart failure.

Keywords: Diuretic therapy, Furosemide, Heart failure

Received: August 31, 2025; Revised: August 31, 2025; Accepted: September 29, 2025; Prepublished online: June 2, 2012; Published: May 20, 2026  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
Mikula J. (The Current Role of Diuretic Therapy in the Treatment of Heart Failure). Cor Vasa. 2026;68(2):196-200. doi: 10.33678/cor.2025.103.
Share...
Download citation
  • BibTeX (.bib)
  • Bookends (.ris)
  • EasyBib (.ris)
  • EndNote (.enw)
  • EndNote 8 (.xml)
  • ISI WoS (.isi)
  • Medlars (.medlars)
  • Mendeley (.ris)
  • MODS (.xml)
  • Papers (.ris)
  • RefWorks (.txt)
  • RefManager (.ris)
  • RIS (.ris)
  • MS Word (.xml)
  • Zotero (.ris)
    • Open full article

    References

    1. Tsao CW, Aday AW, Almarzooq ZI, et al. Heart Disease and Stroke Statistics - 2023 Update: A Report From the American Heart Association. Circulation 2023;147:e93-e621. Go to original source... Go to PubMed...
    2. Ústav zdravotnických informací a statistiky ČR. Srdeční selhání v ČR. Online. Dostupné z: https://www.nzip.cz/clanek/1668-srdecni-selhani-v-cr. [citováno 2024-04-28].
    3. McDonagh TA, Metra M, Adamo M, et al. 2023 Focused Update of the 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J 2023;44:3627-3639. [erratum in Eur Heart J 2024;45:53.] Go to original source...
    4. McDonagh TA, Metra M, Adamo M, et al. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J 2021;42:3599-3726. [erratum in Eur Heart J 2021;42:4901. Go to original source...
    5. Konstam MA, Gheorghiade M, Burnett JC Jr, et al. Effects of Oral Tolvaptan in Patients Hospitalized for Worsening Heart Failure: The EVEREST Outcome Trial. JAMA 2007;297:1319-1331. Go to original source...
    6. Mullens W, Damman K, Harjola VP, et al. The use of diuretics in heart failure with congestion - a position statement from the Heart Failure Association of the European Society of Cardiology. Eur J Heart Fail 2019;21:137-155. Go to original source... Go to PubMed...
    7. Felker GM, Ellison DH, Mullens W, et al. Diuretic Therapy for Patients With Heart Failure: JACC State-of-the-Art Review. J Am Coll Cardiol 2020;75:1178-1195. Go to original source...
    8. Pickkers P, Dormans TP, Russel FG, et al. Direct vascular effects of furosemide in humans. Circulation 1997;96:1847-1852. Go to original source... Go to PubMed...
    9. Testani JM, Chen J, McCauley BD, et al. Potential Effects of Aggressive Decongestion During the Treatment of Decompensated Heart Failure on Renal Function and Survival. J Am Coll Cardiol 2010;56:1759-1765. Go to original source... Go to PubMed...
    10. Cox ZL, Rao VS, Ivey-Miranda JB, et al. Compensatory post-diuretic renal sodium reabsorption is not a dominant mechanism of diuretic resistance in acute heart failure. Eur Heart J 2021;42:4468-4477. Go to original source...
    11. Felker GM, Lee KL, Bull DA, et al. Diuretic strategies in patients with acute decompensated heart failure. N Engl J Med 2011;364:797-805. Go to original source...
    12. Gupta R, Testani J, Collins S. Diuretic resistance in heart failure. Curr Heart Fail Rep 2019;16:57-66. Go to original source... Go to PubMed...
    13. Felker GM, Ellison DH, Mullens W, et al. Diuretic therapy for patients with heart failure: JACC state-of-the-art review. J Am Coll Cardiol 2020;75:1178-1195. Go to original source... Go to PubMed...
    14. Trullàs JC, Morales-Rull JL, Casado J, et al. Combining loop with thiazide diuretics for decompensated heart failure: the CLOROTIC trial. Eur Heart J 2023;44:411-421. Go to original source... Go to PubMed...
    15. Mullens W, Dauw J, Martens P, et al. Acetazolamide in Acute Decompensated Heart Failure with Volume Overload. N Engl J Med 2022;387:1185-1195. Go to original source... Go to PubMed...
    16. Bhatt PR, McNeely EB, Lin TE, et al. Review of Tolvaptan's pharmacokinetic and pharmacodynamic properties and drug interactions. J Clin Med 2014;3:1276-1290. Go to original source... Go to PubMed...
    17. Bart BA, Goldsmith SR, Lee KL, et al. Ultrafiltration in Decompensated Heart Failure with Cardiorenal Syndrome. N Engl J Med 2012;367:2296-2304. Go to original source...
    18. Mentz RJ, Greene SJ, Ambrosy AP, et al. Torsemide Compared With Furosemide for Management of Heart Failure: The TRANSFORM-HF Randomized Trial. JAMA 2023;329:214-223. Go to original source...
    19. Ellison DH. Diuretic resistance: physiology and therapeutics. Fundam Clin Pharmacol 2011;25:115-121.
    20. Rokutan H, Suckow C, von Haehling S, et al. Furosemide induces mortality in a rat model of chronic heart failure. Int J Cardiol 2012;160:20-25. Go to original source... Go to PubMed...
    21. Pfeffer MA, Pfeffer JM, Steinberg C, Finn P. Survival after an experimental myocardial infarction: beneficial effects of long-term therapy with captopril. Circulation 1985;72:406-412. Go to original source... Go to PubMed...
    22. Houser SR, Margulies KB, Murphy AM, et al. Animal models of heart failure: a scientific statement from the American Heart Association. Circ Res 2012;111:131-150. Go to original source... Go to PubMed...
    23. Abassi Z, Goltsman I, Karram T, et al. Aortocaval fistula in rat: a unique model of volume-overload congestive heart failure and cardiac hypertrophy. J Biomed Biotechnol 2011;2011:729497. Go to original source...
    24. Kala P, Gawrys O, Miklovič M, et al. Endothelin type A receptor blockade attenuates aorto-caval fistula-induced heart failure in rats with angiotensin II-dependent hypertension. J Hypertens 2023;41:99-114. Go to original source...
    25. Melenovsky V, Skaroupkova P, Benes J, et al. The course of heart failure development and mortality in rats with volume overload due to aorto-caval fistula. Kidney Blood Press Res 2012;35:167-173. Go to original source... Go to PubMed...

    This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0), which permits non-comercial use, distribution, and reproduction in any medium, provided the original publication is properly cited. No use, distribution or reproduction is permitted which does not comply with these terms.


    Return to the content