Comparison in curative effects of different doses of tolvaptan in elderly patients with chronic heart failure
LI Hongjian
WANG Siyue
Abstract：Objective To investigate the clinical efficacy of different doses of tolvaptan in elderly patients with chronic heart failure(CHF).Methods Elderly CHF patients(n=97)were selected from People's Hospital Affiliated to Shandong First Medical University from Jan.2020 to Jan 2023,and randomly divided into low-dose group(n=48)and high-dose group(n=49).The low-dose group was given therapy of basic cardiotonic-diuretic and tolvaptan(7.5 mg/d),and high-dose group was given therapy of basic cardiotonic-diuretic and tolvaptan(15 mg/d).The changes of heart function,daily urine volume,6-minute walk distance(6MWD),and blood electrolytes were compared between 2 groups before and after treatment.The differences in clinical efficacy and prognostic outcomes were compared between 2 groups.Results The comparison had no statistical significance in left ventricular end-diastolic diameter(LVEDd),left ventricular end-systolic diameter(LVESd),left ventricular ejection fraction(LVEF),interventricular septum thickness of end-diastole(IVSTd),left ventricular posterior wall thickness(LVPWT)and ratio of early diastolic mitral valve flow velocity to late diastolic mitral valve flow velocity(E/A)between 2 groups before and after treatment(P>0.05).The measured values of LVEDd,LVESd,IVSTd and LVPWT decreased significantly(P<0.05),and LVEF and E/A increased significantly(P<0.05)in 2 groups after treatment.The comparison in urine volume had no statistical significance between 2 groups before treatment(P>0.05),and urine volume was significantly lower in low-dose group than that in high-dose group on the 3rd,5th,7th and 14th d after treatment(P<0.05).The comparison in 6MWD and N-terminal pro-brain natriuretic peptide(NT-proBNP)had no statistical significance between 2 groups before treatment(P>0.05),and 6MWD increased and NT-proBNP decreased in 2 groups after treatment(P<0.05).The comparison in blood sodium,blood potassium and blood chlorine had statistical significance between 2 groups before treatment(P>0.05),and blood sodium and blood potassium increased in 2 groups after treatment(P<0.05).The measured values of blood sodium and blood potassium were lower in low-dose group than those in high-dose group(P<0.05).The comparison in clinical efficacy had no statistical significance between 2 groups after treatment(P>0.05).The incidence of adverse reactions was lower in low-dose group than that in high-dose group(14.58%vs.32.65%,P<0.05).Conclusion Tolvaptan achieves good therapeutic effects in elderly CHF patients.When comparing 2 doses of 15 mg/day and 7.5 mg/day,the 7.5 mg/day dose helps reduce the incidence of adverse reactions while ensuring the therapeutic effect.
Keywords：tolvaptanagednesschronic heart failureheart function
Publication Date：2025-11-20
Online Publishing Date：2026-03-25(First online date of this platform, not the publication date of the document)
Pages：5( 1389-1393 )