Objectives To investigate the effectiveness and safety of the combination of passive leg movement and intravenous furosemide in patients with acute decompensated chronic heart failure (CHF).
Methods 62 acute decompensated CHF in-patients with II-IV NYHA class were studied, and randomly divided into the passive exercise group (PM + Fs) and the control group (Fs). Each group included 31 patients. The control group received intravenous 20 mg furosemide after admission, while the passive exercise group received the combination of intravenous 20 mg furosemide plus passive leg movement at 40 cycles min-1 for 15 minutes. The serum N-terminal pro-B-type natriuretic peptide (NT-pro BNP) levels, blood pressure (BP) and heart rate (HR) were measured before and 2 hours after treatment. The 2-hour urinary volume was also recorded.
Results 1. In comparison with the control group, the 2-hour urinary volume in the passive exercise group was significantly higher (656.77 ± 521.94 ml vs 389.03 ± 216.02 ml, P < 0.05).
2. The basic serum NT-pro BNP levels were similar between two groups (P > 0.05). In the control group, the NT-pro BNP level after treatment was significantly higher than that before treatment (5743.75 ± 5958.92 pg/ml vs 3917.99 ± 4707.97 pg/ml, P < 0.05). But in the passive exercise group, the NT-pro BNP level after treatment was significantly lower than that before treatment (3087.61 ± 2423.96 pg/ml vs 3983.14 ± 3375.09 pg/ml, P < 0.05). So the NT-pro BNP level after treatment in the passive exercise group was significantly lower than that in the control group (5743.75 ± 5958.92 pg/ml vs 3087.61 ± 2423.96 pg/ml, P < 0.05).
3. The basic systolic blood pressure, diastolic blood pressure and heart rate were similar between two groups (P > 0.05), and there were no significant changes in all three values between before and after treatment in both groups (P > 0.05).
Conclusions As intravenous furosemide plus passive leg movement enhances diuresis and decrease of the serum NT-pro BNP level without significant BP and HR changes in 2-hour period, this combination therapy may safely and effectively be used in CHF patients.