Differences in pharmacological property between combined therapy of the vasopressin V2-receptor antagonist tolvaptan plus furosemide and monotherapy of furosemide in patients with hospitalized heart failure
| Autor: | Arifumi Kikuchi, Yusuke Ito, Noriyuki Kobayashi, Kenji Nakama, Kenichi Amitani, Hayano Iha, Tsuyoshi Nohara, Naoki Sato, Yuji Maruyama, Shunichi Nakamura, Atsushi Ishizuka, Eisei Yamamoto, Shiro Ishihara, Tatsuya Mitsuishi, Naoto Takahashi, Masahiro Ishikawa, Hideo Tokuyama, Koji Takagi, Satoru Ohkuma, Hajime Imura, Toshiya Omote, Wataru Shimizu, Shota Shigihara, Michiko Sone |
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| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Volume overload Tolvaptan Blood Pressure 030204 cardiovascular system & hematology Inferior vena cava 03 medical and health sciences 0302 clinical medicine Furosemide Internal medicine Extracellular fluid medicine Humans 030212 general & internal medicine Aged Aged 80 and over Heart Failure business.industry Antidiuretic Agents Body Weight Fluid compartments Middle Aged medicine.disease Hospitalization Blood pressure medicine.vein Echocardiography Heart failure Cardiology Drug Therapy Combination Female Cardiology and Cardiovascular Medicine business Antidiuretic Hormone Receptor Antagonists medicine.drug |
| Zdroj: | Journal of Cardiology. 76:499-505 |
| ISSN: | 0914-5087 |
| DOI: | 10.1016/j.jjcc.2020.05.012 |
| Popis: | Background Tolvaptan has been shown to improve congestion in heart failure patients. The purpose of this study was to evaluate the pharmacology and clinical efficacy of combined tolvaptan and furosemide therapy. Methods This study included 40 patients with systemic volume overload who were hospitalized for heart failure. Patients who showed no improvement in the condition after receiving 20 mg intravenous furosemide were included and were randomly selected to receive tolvaptan as an add-on to furosemide or to receive an increased dose of furosemide. We evaluated the bioelectrical impedance analyzer parameters, the parameters of the inferior vena cava using echocardiography, vital signs, body weight, urine output, and laboratory data for 5 days. Results In the changes from baseline between intracellular water volume (ICW) and extracellular water volume (ECW) after additional use of tolvaptan or furosemide from Day 1 to Day 5, there were no significant differences observed between ICW and ECW over 5 days in the tolvaptan + furosemide group, although differences were found in the furosemide group from Day 2 onward. Changes in the respiratory collapse of inferior vena cava increased significantly, and systolic blood pressure decreased significantly only in the furosemide group. Conclusions The present study clearly demonstrates that combined therapy with tolvaptan and furosemide removed excess ICW and ECW to an equal extent, while furosemide alone primarily removed ECW, including intravascular water. |
| Databáze: | OpenAIRE |
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