Efficacy and safety of tolvaptan in treating heart failure
Zhang Dan
Tan Hong
Li Yuehua
Wang Ranran
Abstract：Objective To investigate the efficacy and safety of tolvaptan in treating heart failure.Methods Totally 54 patients with decompensated heart failure from August 2013 to October 2015 were randomly divided into control group and tolvaptan group (27 cases in each group).Both groups were given basic treatment,tolvaptan group was additionally given tolvaptan (15 mg,1 time/d,for 7 days).The degrees of dyspnea,pulmonary rale,edema of lower extremity,the 24 h urine volume,the body mass index (BMI),the serum sodium,the plasma osmotic pressure,the levels of alanine transaminase,aspartate transaminase,plasma creatinine,uric acid,plasma B-type natriuretic peptide,the left ventricular end diastolic diameter,the left ventricular ejection fraction were compared between groups after 7 days of treatment;the adverse reactions were also observed.Results One case in tolvaptan group withdrew from the study because of hypernatremia 4 d after treatment,and 26 cases were finally enrolled.The congestive symptoms including dyspnea,lung rale and lower extremity edema were significantly improved in tolvaptan group compared with that in control group (P ＜ 0.05).After 7 days,the daily urine volume,serum sodium,the plasma osmotic pressure were significantly higher than those before treatment and those in control group [(1 982±249) mlvs (1 260±400),(1 594 ±311) ml,(138 ±5) mmol/Lvs (134 ±5),(135 ± 5) mmol/L,(291 ± 10) mOsm/L vs (277 ± 11),(279 ± 10) mOsm/L] (P ＜ 0.05);in tolvaptan group BMI decreased to (24.2 ± 2.6) kg/m2 from (24.4 ± 2.5) kg/m2 after treatment (P ＜ 0.01);the other monitoring indexes were not significantly different between groups (P ＞ 0.05).In tolvaptan group,the adverse reactions included dry mouth (9 cases),frequent micturition (2 cases),elevated serum sodium (1 case);in control group,the adverse reactions included dry mouth (8 cases) and kaliopenia (2 cases).Conclusions Tolvaptan can improve the signs and symptoms of heart failure in a short time,but it can increase the serum sodium level,therefore serum sodium should be closely monitored for preventing the hypernatremia.
Keywords：Heart failureTolvaptanSerum sodium
Publication Date：2016-01-01
Online Publishing Date：2026-09-14(First online date of this platform, not the publication date of the document)
Pages：5( 469-473 )