Echocardiographic characteristics of patients with acute heart failure requiring tolvaptan: a retrospective study
Yasuki Nakada1, Satoshi Okayama2, Tomoya Nakano1
1First Department of Internal Medicine, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan.
Background:
No study has investigated the admission echocardiographic characteristics of acute heart failure (AHF) patients who are resistant to conventional diuretics and require tolvaptan.
Methods:
We retrospectively analyzed the echocardiographic characteristics of AHF patients who were resistant to conventional diuretics and took tolvaptan (tolvaptan group: 26 patients), and compared them to those who were sensitive to conventional diuretics (conventional group: 180 patients).
Results:
The tolvaptan group had a higher left atrial volume index (96.0 ± 85.0 mL/m2 vs. 45.8 ± 25.9 mL/m2, p < 0.0001), maximum inferior vena cava diameter (20.7 ± 6.9 mm vs. 18.1 ± 4.2 mm, p < 0.01), and higher tricuspid regurgitation grade (1.1 ± 0.8 vs. 0.8 ± 0.6, p < 0.05) than the conventional group. However, the left ventricular ejection fraction and end diastolic diameter were similar between the groups. Responders of tolvaptan had no significant echocardiographic differences compared to the non-responders.
Conclusions:
The admission echocardiographic characteristics of AHF patients requiring tolvaptan included a larger left atrium, inferior vena cava, and more severe tricuspid regurgitation. Echocardiography may provide useful information for the early and appropriate initiation of tolvaptan.
Related Concept Videos
Heart Failure IV: Classification and Diagnostic Evaluation
Heart Failure III: Clinical Manifestations
Heart Failure II: Pathophysiology
Heart Failure Drugs: Inotropic Agents
Aortic Regurgitation II: Clinical Features and Diagnostic Tests
Acute Coronary Syndrome III: Diagnostic Studies


