The Effect of Non-Hydrochlorothiazide Diuretic Therapy on Symptoms and Diastolic Parameters in Obese Patients with Bendopnea
Yücel Kanal1, Görkem Ayhan2, Canan Elif Yıldız3, Mehmet Fatih Aygün4, Adem Çelik4, Idris Yakut5, Hatice Eftal Şeyda Kanal6, Omaç Tüfekçioğlu71Department of Cardiology, Sivas Cumhuriyet University, Sivas, Türkiye2Department of Cardiology, Van Education and Research Hospital, Van, Türkiye
3Department of Cardiology, Yeditepe University Hospital, İstanbul, Türkiye
4Department of Cardiology, Tokat State Hospital, Tokat, Türkiye
5Department of Cardiology, Sincan Education and Research Hospital, Ankara, Türkiye
6Department of Cardiology, Tokat Gaziosmanpaşa University, Tokat, Türkiye
7Department of Cardiology, Ankara Bilkent City Hospital, Ankara, Türkiye
INTRODUCTION: Bendopnea is defined as the onset of dyspnea within 30 s of bending forward and is linked to increased right atrial and post-capillary wedge pressures. Diuretics reduce intravascular volume by inhibiting sodium reabsorption, thereby lowering cardiac filling pressures. This study aimed to evaluate the effects of non-hydrochlorothiazide (HCTZ) diuretics on symptoms and diastolic parameters in obese patients with bendopnea.
METHODS: This retrospective, single-center study included 120 obese patients presenting with bendopnea to the cardiology outpatient clinic. Group 1 comprised patients who either received no medication or were prescribed only HCTZ. Group 2 included those treated with non-HCTZ diuretics (spironolactone, spironolactone + HCTZ, or indapamide). After 1 month, symptom status and clinical parameters were reassessed.
RESULTS: The mean age was 57±9.1 years, with 90% female participants. At 1-month follow-up, bendopnea frequency was significantly lower in Group 2 compared to Group 1 (16.1% vs. 96.6%; p<0.001). Improvements were also observed in systolic mean blood pressure, NT-proBNP levels, and E/e′ values in patients in Group 2.
DISCUSSION AND CONCLUSION: Non-HCTZ diuretics significantly alleviated bendopnea symptoms and improved diastolic parameters in obese patients. These findings suggest that non-HCTZ diuretics may offer symptomatic and hemodynamic benefits in this population.
Keywords: Bendopnea, diastolic function, diuretic, hydrochlorothiazide, obesity.
Manuscript Language: English