Acute Hemodynamic Effects of Tolvaptan, a Vasopressin V2 Receptor Blocker, in Patients With Symptomatic Heart Failure and Systolic Dysfunction

Results Tolvaptan at all doses significantly reduced pulmonary capillary wedge pressure ( 6.4 4.1 mm Hg, 5.7 4.6 mm Hg, 5.7 4.3 mm Hg, and 4.2 4.6 mm Hg for the 15-mg, 30-mg, 60-mg, and placebo groups, respectively; p 0.05 for all tolvaptan vs. placebo). Tolvaptan also reduced right atrial pressure ( 4.4 6.9 mm Hg [p 0.05], 4.3 4.0 mm Hg [p 0.05], 3.5 3.6 mm Hg, and 3.0 3.0 mm Hg for the 15-mg, 30-mg, 60-mg, and placebo groups, respectively) and pulmonary artery pressure ( 5.6 4.2 mm Hg, 5.5 4.1 mm Hg, 5.2 6.1 mm Hg, and 3.0 4.7 mm Hg for the 15-mg, 30-mg, 60-mg, and placebo groups, respectively; p 0.05). Tolvaptan increased urine output by 3 h in a dose-dependent manner (p 0.0001), without changes in renal function.