Abstract
Hyponatremia is widely known to be one of the strong prognostic predictors for heart failure (HF). However, there are few reports on the clinical benefits of correcting hyponatremia to improve HF prognosis. Although randomized clinical trials including EVEREST have not demonstrated prognostic benefits of the vasopressin V2 receptor antagonist tolvaptan, increasing evidence suggests its novel therapeutic potential in preventing low cardiac output during decongestion through increasing serum osmolarity, especially in severe hyponatremia with extravascular volume excess. In addition to being an alternative option for HF patients with renal dysfunction resistant to loop diuretics, tolvaptan may serve as a useful therapeutic tool to prevent or minimize cardiovascular events including HF exacerbation. (Jpn J Clin Pharmacol Ther 2012; 43(5): 305-309)
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