Assessment of Quality of Life in Patients with Chronic Systolic Heart Failure, Impact of Diuretics on Quality of Life

Abstract

Introduction. Quality of life (QoL) of patients with chronic heart failure (CHF) is an integral part of a comprehensive analysis of their condition and helps to evaluate the effectiveness of various methods of treatment and rehabilitation. Using different medicines, including diuretics, has a significant impact on this indicator. According to the researches BADAPIC and EPISERVE, 86.0 % of people with CHF are treated with diuretic drugs constantly. The purpose of our study was to ascertain the impact of these drugs on QоL in patients with CHF. Aim. To analyse the current literature information in order to assess the quality of life in patients with systolic chronic heart failure and the effect of diuretic therapy on this indicator. Materials and methods. Retrospective analysis of 50 contemporary literary resources on the topic. Results. Determining the level of QоL based on the analysis of indicators of patient self- assessment of restrictions that caused the disease. The main tool for this is the questionnaires. Past studies have found a correlation between the results of a survey among patients with CHF and a number of clinical and demographic indicators. Because QоL indicators can be used for stratification of patients with heart failure risk for unfavourable prognosis. Little is known about how to evaluate the effect of different drugs on QоL in patients with CHF. Diuretics are no exception to this rule. Most studies on the impact of diuretic treatment on QoL in patients with CHF demonstrate superiority of loop diuretics torasemide compared to furosemide. This is caused by its pharmacokinetic and pharmacodynamic characteristics, providing it a higher safety profile, metabolic neutrality, faster and more substantial clinical improvement in patients with decompensated state, respectively, lower incidence and duration of hospitalization. In addition, torasemide treatment is more cost-effective compared to furosemide. Torasemide slow release (SR) in the study showed comparable torasemide immediate release (IR) safety profile and diuretic effect. However, it caused significantly fewer emergency and urination in the first 6 hours after taking a diuretic, causing fewer domestic constraints and better perceived subjectively by patients. Obtained facts give a reason to believe that torasemide SR is more «comfortable» diuretic during prolonged maintenance treatment that can save a maximum degree of social activity and minimize its negative impact on QoL of patients with CHF. Conclusions. Assessment of quality of life is an integral part of a comprehensive analysis of the patient, forecasting of possible adverse events, stratification of patients at risk adverse effects and determine the effectiveness of different diagnostic, therapeutic and preventive measures. During an extended maintenance of diuretic in patients with systolic chronic heart failure a better effect on the quality of life indicators has a loop diuretics torasemide, especially a torasemide with slow release.

Keywords

• chronic systolic heart failure
• diuretic therapy
• quality of life