| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH |
|
|
|
|||||||
|
|||||||||
1 Cardiorenal Research Laboratory, Mayo Clinic and Mayo Clinic College of Medicine, Rochester, MN, USA
2 New Orleans Center for Clinical Research, New Orleans, LA, USA
3 Otsuka Maryland Research Institute, Rockville, MD, USA
* To whom correspondence should be addressed. E-mail: costello.lisa{at}mayo.edu.
Diuretics are frequently required to treat fluid retention in patients with congestive heart failure (CHF). Unfortunately, they can lead to a decline in renal function, electrolyte depletion, and neurohumoral activation. Arginine vasopressin (AVP) promotes renal water reabsorption via the V2 receptor, and its levels are increased in CHF. This study was designed to assess the effects of a single oral dose of tolvaptan, a selective V2 receptor blocker, in the absence of other medications, on renal function in human CHF and to compare this to the effects of a single oral dose of furosemide. We hypothesized that V2 receptor antagonism would yield a diuresis comparable to furosemide but would not adversely affect renal hemodynamics, plasma electrolyte concentration, or neurohumoral activation in stable human CHF. Renal and neurohumoral effects of tolvaptan and furosemide were assessed in an open-label, randomized, placebo-controlled crossover study in 14 patients with NYHA II-III CHF. Patients received placebo or tolvaptan 30 mg on Day 1 and were crossed over to the other medication on Day 3. On Day 5, all subjects received furosemide 80 mg. Tolvaptan and furosemide induced similar diuretic responses. Unlike tolvaptan, furosemide increased urinary sodium and potassium excretion and decreased renal blood flow. Tolvaptan, furosemide, and placebo did not differ with respect to mean arterial pressure, glomerular filtration rate, or serum sodium and potassium. We conclude that tolvaptan is an effective aquaretic with no adverse effects on renal hemodynamics or serum electrolytes in patients with mild to moderate heart failure.heart failure.
This article has been cited by other articles:
|
|
 |
|
  J. J. Finley IV, M. A. Konstam, and J. E. Udelson Arginine Vasopressin Antagonists for the Treatment of Heart Failure and Hyponatremia Circulation, July 22, 2008; 118(4): 410 - 421. [Full Text] [PDF]
|
|
|
|
 |
|
 T. A. Schweiger and M. M. Zdanowicz Vasopressin-receptor antagonists in heart failure Am. J. Health Syst. Pharm., May 1, 2008; 65(9): 807 - 817. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. Damman, G. Navis, T. D.J. Smilde, A. A. Voors, W. van der Bij, D. J. van Veldhuisen, and H. L. Hillege Decreased cardiac output, venous congestion and the association with renal impairment in patients with cardiac dysfunction Eur J Heart Fail, September 1, 2007; 9(9): 872 - 878. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. P. Rossi Arginine Vasopressin Receptor Antagonists for Heart Failure: A Winter Climbing to the Everest's Tip? J. Am. Coll. Cardiol., June 5, 2007; 49(22): 2160 - 2162. [Full Text] [PDF]
|
|
|
|
 |
|
 M. A. Konstam, M. Gheorghiade, J. C. Burnett Jr, L. Grinfeld, A. P. Maggioni, K. Swedberg, J. E. Udelson, F. Zannad, T. Cook, J. Ouyang, et al. Effects of Oral Tolvaptan in Patients Hospitalized for Worsening Heart Failure: The EVEREST Outcome Trial JAMA, March 28, 2007; 297(12): 1319 - 1331. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. M. deGoma, R. H. Vagelos, M. B. Fowler, and E. A. Ashley Emerging Therapies for the Management of Decompensated Heart Failure: From Bench to Bedside J. Am. Coll. Cardiol., December 19, 2006; 48(12): 2397 - 2409. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. W. Schrier, P. Gross, M. Gheorghiade, T. Berl, J. G. Verbalis, F. S. Czerwiec, C. Orlandi, and the SALT Investigators Tolvaptan, a Selective Oral Vasopressin V2-Receptor Antagonist, for Hyponatremia N. Engl. J. Med., November 16, 2006; 355(20): 2099 - 2112. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH |
| Visit Other APS Journals Online |
