[The place of diuretics in the treatment of chronic heart failure. Part I].

In series of papers the authors analyze the literature data concerned with clinical pharmacology of four main classes of diuretics and their use in long-term treatment of congestive chronic heart failure (CHF). Part I is devoted to basic clinical pharmacology of three main classes of diuretics -- loop, thiazide and potassium-sparing. The site of action in nephron, mechanisms and duration of action different loop and thiazide diuretics with emphasis to furosenide, torasemide, hydrochlorothiazide, metolazone and indapamide as well as contraindications and limitations for their use in the complex treatment of CHF are considered in detail. In long-term comparative studies showed long acting loop diuretic torasemide improved symptomatology and functional class of NYHA in patients with CHF in compared with furosenide. Thiazide-like diuretic indapamide does also act as vasodilator and decreases afterload of left ventricle of heart. But indapanide should be used with special caution because of their capacity to prolong the Q-T interval, which associates with polymorphic ventricular tachycardia, or torsades de poites.