Who Needs Longer Tolvaptan Treatment?

Abstract:

:The vasopressin receptor 2 (V2) receptor antagonist tolvaptan is an aquaretic agent that has been approved for heart failure patients with volume overload in Japan. In this study (SMILE study), we investigated patient characteristics and effectiveness in both a 14 days and shorter treated group (14DS) and 15 days and longer treated group (15DL). The results showed that the patients in the 15DL group had low cardiac output with intensive diuretic administration (ie, diuretic resistance). The congestive symptoms were greatly improved within 14 days of treatment in both the 14DS and 15DL groups. Further improvements in lower limb edema, pulmonary congestion, dyspnea, third sound, and rales after 2 weeks were statistically significant in the 15DL group, but the amount of improvement was subtle and the 15DL group might have consisted of a considerable number of "non-responders". Therefore, identifying "responders" by biomarkers and conducting a prospective randomized study is required to validate our findings.

journal_name

Int Heart J

authors

Kinugawa K,Inomata T,Sato N,Yasuda M,Shimakawa T,Bando K,Fukuta Y

doi

10.1536/ihj.16-249

subject

Has Abstract

pub_date

2017-02-07 00:00:00

pages

30-35

issue

1

eissn

1349-2365

issn

1349-3299

journal_volume

58

pub_type

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