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[Metolazone in the treatment of refractory heart insufficiency. Experience of 10 cases].

OBJECTIVE
To evaluate efficacy of the association furosemide-metolazona in ten retrospective cases of Congestive heart failure, furosemide resistant.


SETTING
Service of cardiology, patients admitted in two year period, from September 1985 through May 1987.


PATIENTS
Revision of ten cases of congestive heart failure who was administered metolazona after inadequate response to furosemide. The etiology of congestive heart failure included three cases of ischemic heart disease, two cases of dilated myocardiopathy, two cases of rheumatic valvular cardiopathy, one case of congenital heart disease, two cases with no established etiology. All cases was in functional class III and IV of NYHA classification.


RESULTS
Good results were obtained in eight patients. The other two were not different in etiology of heart failure, renal function, serum electrolytics and associated therapy. Diuresis was independent of the creatinine plasmatic values.


CONCLUSION
In our study, in eight of ten cases, metolazona had additive diuretic effect when associated to furosemide in patients with congestive heart failure.