Urine Osmolality-Guided Tolvaptan Therapy in Decompensated Heart Failure

Association between plasma concentration of tolvaptan and urine volume in acute decompensated heart failure patients with fluid overload.

BACKGROUND Tolvaptan (TLV) is a useful diuretic for acute decompensated heart failure (ADHF) with fluid overload, but its clinical response varies between patients. The aim of this study is to investigate whether plasma TLV concentrations correlate with the urine volume. METHODS ADHF inpatients with evidence of fluid overload and total urine volume < 1,500 mL 24 hours after initial intravenou...

Vasodilator therapy for decompensated heart failure.

odium nitroprusside is appropriate for the acute treatment f congestive heart failure. The starting dose is 0.3 to 0.5 g/kg/min titrated to goal attainment of desired hemodyamics but usually not beyond 5 g/kg/min. Doses of 10 g/kg/min or sustained administration will result in excesive cyanide production, which may occasionally lead to yanide poisoning and may rarely lead to the development f m...

Impact of chronic kidney disease on the diuretic response of tolvaptan in acute decompensated heart failure

AIM This study investigated the relationship between the initial diuretic response to tolvaptan and clinical predictors for tolvaptan responders in patients with acute decompensated heart failure (ADHF). METHODS AND RESULTS Patients (153) with ADHF (clinical scenario 2 or 3 with signs of fluid retention) who were administered tolvaptan were enrolled. Tolvaptan (15 or 7.5 mg) was administered ...

Clinical utility of early use of tolvaptan in very elderly patients with acute decompensated heart failure

OBJECTIVE The establishment of an optimal strategy for elderly patients with acute decompensated heart failure (ADHF) is currently an important issue. Particularly in very elderly (VE) patients, ADHF is associated with a poor prognosis. We therefore aimed to evaluate the efficacy and safety of the early use of tolvaptan (TLV) in VE patients. METHODS Of 245 patients with ADHF admitted between ...

Tolvaptan in the very elderly with acute decompensated heart failure-a therapeutic option worth of consideration