Critical Care: Vasopressin antagonist may boost treatment for heart failure

August 2004 
Volume 34  Number 8
Pages 32cc8 - 32cc8
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    Diuretics, the mainstay of treatment for heart failure, can cause electrolyte abnormalities and worsen renal function. A new study suggests that giving tolvaptan, a vasopressin antagonist, in addition to standard therapy can reduce fluid volume in patients with heart failure without harming electrolyte balance or renal function.

    In the study, 319 patients were randomly assigned to receive 30, 60, or 90 mg/day of oral tolvaptan or placebo in addition to standard therapy, including non-potassium-sparing diuretics. Patients in the study had left ventricular ejection fractions less than 40%, were hospitalized for heart failure, and continued to have signs and symptoms of systemic congestion despite standard therapy.

    After 24 hours of treatment, patients in the tolvaptan groups had reduced body weights compared with patients receiving placebo, but didn't have changes in heart rate or blood pressure and didn't have hypokalemia ...

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