Abstract
We explored the role of RV function for the prediction of Tolvaptan (TLV) in patients with heart failure with reduced EF(HFrEF). 55 patients admitted for acute decompensated HF were enrolled (Age73 years, 35male). EF were uniformly reduced (LVEF=32%). They were administered TLV at 7.5-15 mg/day for one week. Non-response was defined as no evidence of a 1 kg decrease in body weight (BW) during a week. Blood sampling and echocardiography, including strain imaging, were performed just prior to starting TLV. Vivid-q and EchoPAC-PC (GE, Norway) were used for echocardiographic analyses. We analyzed LV, LA and RV strain. 10 patients were non-responders (δBW=0.6kg). Logistic regression analysis showed that RV dysfunction and renal function (eGFR ml/min/1.73m2)were significant predictors for non-response to TLV RV dysfunction can be an important predictor of the effectiveness of TLV in patients with HFrEF.TableLogistic regression analysis foe non-respondsOdds ratio95%CIp ValueAge1.0210.971-1.0850.443Female (yes)2.5710.667-10.3580.167BNP/100 (pg/ml)1.0150.924-1.1060.726eGFR (ml/min./1.73m2)0.9570.901-0.9960.028Na/10 (mEq/l)0.7610.329-1.0560.107EF (%)1.0110.952-1.0690.713E/e′1.0080.926-1.0960.815GLS1.0390.795-1.3950.781LA stain0.9310.783-1.0710.339RV strain1.2721.082-1.5710.002TAPSE0.8680.748-0.9830.026 Open table in a new tab
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