Tolvaptan can improve clinical course in responders
Teruhiko Imamura1, Koichiro Kinugawa, Shun Minatsuki
1Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo.
International Heart Journal
|December 7, 2013
Summary
Tolvaptan (TLV) responders, identified by increased urine volume (UV) on day 1, showed improved heart failure (HF) symptoms. This definition accurately predicts clinical outcomes in decompensated HF patients.
Area of Science:
- Nephrology
- Cardiology
- Pharmacology
Background:
- Previous studies defined tolvaptan (TLV) responders by increased urine volume (UV) on day 1.
- Responders and non-responders to TLV are hypothesized to have different clinical trajectories.
Purpose of the Study:
- To validate the definition of TLV responders using clinical parameters one week after TLV administration.
- To assess the clinical significance of early UV response to TLV in decompensated heart failure (HF).
Main Methods:
- Retrospective analysis of 85 hospitalized decompensated HF patients receiving TLV (3.75-15 mg/day).
- Comparison of clinical data at baseline and one week post-TLV administration.
- Definition of responders based on increased UV on day 1 post-TLV.
Main Results:
- 70.6% of patients (n=60) were classified as responders.
- Non-responders were older with higher creatinine and lower baseline urine osmolality (U-OSM).
- Responders showed decreased body weight, B-type natriuretic peptide, and HF symptoms; non-responders did not.
Conclusions:
- Early increase in UV following TLV administration is a valid predictor of clinical improvement in HF.
- The definition of TLV responders based on day 1 UV is clinically relevant for decompensated HF management.
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