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Importance of early use of tolvaptan in hyponatremic acutely decompensated heart failure patients, a retrospective study.
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Department of Cardiology, Division of Heart & Lungs, University Medical Center Utrecht, University of Utrecht, Utrecht, The Netherlands.
Background: Hyponatremia is one of the complicating findings in acute decompensated heart failure. Decrease in cardiac output and systemic blood pressure triggers activation of renin-angiotensin-aldosterone system, antidiuretic hormone, and norepinephrine due to the perceived hypovolemia. Fluid-overloaded heart failure patients are commonly treated with loop diuretics, acutely decompensated heart failure patients tend to be less responsive to conventional oral doses of a loop diuretic, while other different diuretics could work in different part of nephron circulation system.
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