AI Article Synopsis
- The study investigates the use of tolvaptan, an adjunctive therapy, in treating acute decompensated heart failure (ADHF) patients with preserved left ventricular ejection fraction (LVEF).
- It compares the effects of tolvaptan versus conventional diuretics on cardiac sympathetic nerve activity (CSNA), utilizing methods like cardiac imaging to assess changes.
- The findings suggest that tolvaptan can lead to rapid decongestion without negatively impacting CSNA, which is beneficial for managing heart failure symptoms.
Article Abstract
Aims: Acute decompensated heart failure (ADHF) is generally treated by decongestion using diuretic therapy. However, the use of loop diuretics is associated with increased cardiac sympathetic nerve activity (CSNA). We aimed to evaluate the effect of adjunctive tolvaptan therapy on CSNA in ADHF patients with preserved left ventricular ejection fraction (LVEF).
Methods And Results: We enrolled 51 consecutive ADHF patients with LVEF ≥45%. Patients were randomly assigned to receive either tolvaptan add-on (n = 25) or conventional diuretic therapy (n = 26). Cardiac iodine-123 metaiodobenzylguanidine (MIBG) imaging was performed after stabilisation of heart failure symptoms, and the cardiac MIBG heart-to-mediastinum ratio (HMR) and washout rate (WR) were calculated. There were no significant differences in the body weight change and total urine volume during 2 days after randomisation or in the HMR on delayed image (HMR(d)) and WR between the tolvaptan and conventional groups. After stratification based on the median change in body weight, the patients with higher weight reduction had a significantly lower HMR(d) (P = 0.0128) and tended to have a higher WR (P = 0.0786) in the conventional group, whereas the cardiac MIBG imaging results were not influenced by body weight reduction in the tolvaptan group.
Conclusions: Adjunctive tolvaptan therapy may provide rapid decongestion without a harmful effect on CSNA in ADHF patients with preserved LVEF.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7261536 | PMC |
| http://dx.doi.org/10.1002/ehf2.12690 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
The role of tolvaptan add-on therapy in patients with acute heart failure: a systematic review and network meta-analysis.
Front Cardiovasc Med
May 2024
Department of Cardiology and Vascular Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Dr. Sardjito Hospital, Yogyakarta, Indonesia.
Background: Several conflicting reviews have concluded that the use of loop diuretics is associated with poorer clinical and safety outcomes. Therefore, this study aimed to investigate the efficacy and safety of tolvaptan as an adjunct to conventional diuretic therapy in patients with acute heart failure (AHF).
Methods: A comprehensive search was conducted on PubMed, Embase, ProQuest, EBSCO, and Cochrane Library until 24 May 2023 to identify randomized controlled trials that compared the effects of tolvaptan with conventional therapy and placebo in patients with AHF.
Diuretic Strategies in Acute Decompensated Heart Failure: A Narrative Review.
Can J Hosp Pharm
January 2024
, BScPharm, ACPR, is a Clinical Pharmacist with the Calgary Zone, Alberta Health Services, Calgary, Alberta.
Background: Heart failure is a common condition with considerable associated costs, morbidity, and mortality. Patients often present to hospital with dyspnea and edema. Inadequate inpatient decongestion is an important contributor to high readmission rates.
View Article and Find Full Text PDFPeritoneal Dialysis for Refractory Heart Failure from a Congenitally Corrected Transposition of the Great Arteries who has not Undergone Definitive Surgery: A Case Report.
Acta Med Philipp
April 2023
Department of Adult Cardiology, Philippine Heart Center.
Heart failure (HF) is a major cause of significant morbidity, mortality, and hospitalization worldwide including the Philippines. Congenitally corrected transposition of the great arteries (C-TGA) occurs when the right atrium enters the morphological left ventricle which gives rise to the pulmonary artery and the left atrium communicates with the right ventricle which gives rise to the aorta. Heart failure can occur in C-TGA especially if associated with other heart defects.
View Article and Find Full Text PDFAdult human kidney organoids originate from CD24 cells and represent an advanced model for adult polycystic kidney disease.
Nat Genet
November 2022
Institute of Experimental Medicine and Systems Biology, Medical Faculty, RWTH Aachen University, Aachen, Germany.
Article Synopsis
- Scientists found that kidney organoid models called tubuloids come from a special type of cell called CD24 epithelial cells.
- These tubuloids work like real human kidney tubules and can be used to study a common kidney disease called autosomal dominant polycystic kidney disease (ADPKD).
- The researchers showed that a drug called tolvaptan can help reduce the size of cysts in these tubuloids, proving they are useful for studying kidney diseases.
A systematic review of the evidence supporting post-operative diuretic use following cardiopulmonary bypass in children with Congenital Heart Disease.
Cardiol Young
May 2021
Department of Pediatrics, Duke University School of Medicine, Durham, NC, USA.
Background: Paediatric cardiac surgery on cardiopulmonary bypass induces substantial physiologic changes that contribute to post-operative morbidity and mortality. Fluid overload and oedema are prevalent complications, routinely treated with diuretics. The optimal diuretic choice, timing of initiation, dose, and interval remain largely unknown.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!