Short-term efficacy of tolvaptan combined with torasemide in treatment of elderly patients with heart failure

Abstract

Objective To observe the short-term efficacy and safety of tolvaptan combined with torasemide in treating elderly patients with heart failure. Methods Ninety aged patients with heart failure treated at the First Hospital of Shanxi Medical University in 2016 were retrospectively selected and divided into a torasemide group, a tolvaptan group, and a combination group, with 30 cases in each group. All patients were regularly treated with vasodilator, RAAS inhibitors, beta-blockers and so on. Besides, the torasemide group was given torasemide 40 mg/d, the tolvaptan group was treated with tolvaptan 15 mg/d, and the combination group was treated with tolvaptan 15 mg/d and torasemide 20 mg/d. After 5 days of treatment, we observed the improvement of heart failure symptoms and the changes of cardiac and renal function indexes such as 24 h urine output, electrolytes, N-terminal pro-brain natriuretic peptide (NT-proBNP), estimated glomerular filtration rate (eGFR), renal resistive index (RRI), cystatin C (Cys-C), and uric acid (UA). Results After treatment, heart failure symptoms were significantly improved in all the three groups of patients. Compared with the torasemide group, heart failure symptoms of patients in the tolvaptan group and combination group improved significantly (P 0.05). Compared with the torasemide group, 24 h urine volume, serum sodium, and eGFR in the tolvaptan group and combination group increased significantly, and NT-proBNP, UA, Cys-C, and RRI levels significantly decreased (P 0.05). Conclusion The combination of tolvaptan and torasemide is effective in elderly patients with heart failure and can significantly increase serum sodium concentration and reduce the risk of kidney injury with good safety. In addition, the combination treatment can shorten hospitalization duration. Key words: Tolvaptan; Heart failure; Cardiac function; Renal function