Ishido Hirotaka, Senzaki Hideaki
Department of Pediatric Cardiology, International Medical Center, Saitama Medical University, 1397-1 Yamane, Hidaka, Saitama 350-1298, Japan.
Cardiovasc Hematol Disord Drug Targets. 2008 Jun;8(2):127-32. doi: 10.2174/187152908784533685.
Diuretics play an essential role in modern cardiovascular therapy, and are currently recommended for the treatment of congestive heart failure. Torasemide has been developed as a newer type of loop diuretic with a longer half-life, longer duration of action, and higher bioavailability compared to the most commonly used loop diuretic, furosemide. Torasemide also appears to have additional actions beyond the pure diuretic effect, such as anti-aldosterone effect and vasorelaxation effect. Studies have also investigated whether the superior pharmacokinetics and pharmacological activity of torasemide result in a favorable clinical outcome. Their results have indicated that, in comparison with furosemide, torasemide improves left ventricular function, reduces mortality as well as the frequency and duration of heart failure-related hospitalization, and improves quality of life, exercise tolerance and NYHA functional class in patients with congestive heart failure. Thus, torasemide appears to be a promising loop diuretic that contributes to a better management of patients with heart failure. Definitive clinical trials in a double-blind fashion are warranted.
利尿剂在现代心血管治疗中发挥着重要作用，目前被推荐用于治疗充血性心力衰竭。托拉塞米是一种新型的襻利尿剂，与最常用的襻利尿剂呋塞米相比，其半衰期更长、作用持续时间更长且生物利用度更高。托拉塞米似乎除了具有单纯的利尿作用外，还具有其他作用，如抗醛固酮作用和血管舒张作用。研究还调查了托拉塞米优越的药代动力学和药理活性是否会带来良好的临床结果。其结果表明，与呋塞米相比，托拉塞米可改善左心室功能，降低死亡率以及与心力衰竭相关的住院频率和持续时间，并改善充血性心力衰竭患者的生活质量、运动耐量和纽约心脏协会（NYHA）心功能分级。因此，托拉塞米似乎是一种有前景的襻利尿剂，有助于更好地管理心力衰竭患者。有必要进行双盲的确定性临床试验。
