Safety and efficacy of tolvaptan on patients with heart failure complicated by diuretic resistance

Abstract

Objective To evaluate the efficacy and safety of tolvaptan on patients with heart failure. Methods Fifty-six patients with heart failure were selected and received routine diuretic therapy, but the physical signs and symptoms of heart failure were not improved. So the patients recived tolvaptan tablets treatment immediately. The heart failure in patients was evaluated before and after treatment with tolvaptan, including the outcome of the treatment, degree of edema and classification of the heart function of the New York Heart Association (NYHA). The clinical characteristics of the patients were evaluated, including blood pressure, serum creatinine, unit time urine volume, body mass, blood sodium and blood NT-proBNP. The adverse reactions were observed. Results After treatment, the degree of edema and cardiac function were significantly improved in all patients, and the difference was statistically significant (P<0.05). Fifty-one patients were improved and discharged from hospital, the improvement rate was 91.1%. A total of 27 patients with hyponatremia were hospitalized, and 2 patients were discharged from hospital after treatment. The unit time urine volume, blood sodium and systolic pressure were significantly better than those before treatment, the difference was statistically significant (P<0.05). All patients didn’t have syncope, amaurosis or other major adverse reactions. Conclusions For the patients with diuretic resistance in the treatment of heart failure, taking tolvaptan tablets can correct hyponatremia, improve cardiac function, increase the amount of urine and is appropriate to reduce the patient’s systolic blood pressure. It is worthy of clinical application. Key words: Diuretic resistance; Tolvaptan; Heart failure