کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
2952270 1577397 2008 6 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Acute Hemodynamic Effects of Tolvaptan, a Vasopressin V2 Receptor Blocker, in Patients With Symptomatic Heart Failure and Systolic Dysfunction : An International, Multicenter, Randomized, Placebo-Controlled Trial
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی کاردیولوژی و پزشکی قلب و عروق
پیش نمایش صفحه اول مقاله
Acute Hemodynamic Effects of Tolvaptan, a Vasopressin V2 Receptor Blocker, in Patients With Symptomatic Heart Failure and Systolic Dysfunction : An International, Multicenter, Randomized, Placebo-Controlled Trial
چکیده انگلیسی

ObjectivesThis study sought to assess the acute hemodynamic effect of vasopressin V2 receptor antagonism.BackgroundIn decompensated heart failure (HF), tolvaptan, a vasopressin V2 receptor antagonist, has been shown to improve congestion. It has not yet been established whether these improvements may be associated with the hemodynamic effects of tolvaptan.MethodsA total of 181 patients with advanced HF on standard therapy were randomized to double-blind treatment with tolvaptan at a single oral dose (15, 30, or 60 mg) or placebo.ResultsTolvaptan at all doses significantly reduced pulmonary capillary wedge pressure (−6.4 ± 4.1 mm Hg, −5.7 ± 4.6 mm Hg, −5.7 ± 4.3 mm Hg, and −4.2 ± 4.6 mm Hg for the 15-mg, 30-mg, 60-mg, and placebo groups, respectively; p < 0.05 for all tolvaptan vs. placebo). Tolvaptan also reduced right atrial pressure (−4.4 ± 6.9 mm Hg [p < 0.05], −4.3 ± 4.0 mm Hg [p < 0.05], −3.5 ± 3.6 mm Hg, and −3.0 ± 3.0 mm Hg for the 15-mg, 30-mg, 60-mg, and placebo groups, respectively) and pulmonary artery pressure (−5.6 ± 4.2 mm Hg, −5.5 ± 4.1 mm Hg, −5.2 ± 6.1 mm Hg, and −3.0 ± 4.7 mm Hg for the 15-mg, 30-mg, 60-mg, and placebo groups, respectively; p < 0.05). Tolvaptan increased urine output by 3 h in a dose-dependent manner (p < 0.0001), without changes in renal function.ConclusionsIn patients with advanced HF, tolvaptan resulted in favorable but modest changes in filling pressures associated with a significant increase in urine output. These data provide mechanistic support for the symptomatic improvements noted with tolvaptan in patients with decompensated HF. (Heart Pressure Assessment Study With Tolvaptan to Treat Congestive Heart Failure; NCT00132886)

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Journal of the American College of Cardiology - Volume 52, Issue 19, 4 November 2008, Pages 1540–1545
نویسندگان
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