Impact of Continuous Administration of Tolvaptan on Preventing Medium-Term Worsening Renal Function and Long-Term Adverse Events in Heart Failure Patients with Chronic Kidney Disease

Nakano, Yusuke; Mizuno, Tomofumi; Niwa, Toshimitsu; Mukai, Kanae; Wakabayashi, Hisao; Watanabe, Atsushi; Ando, Hirohiko; Takashima, Hiroaki; Murotani, Kenta; Waseda, Katsuhisa; Amano, Tetsuya

doi:10.1536/ihj.16-625

Cited by 27 publications

(20 citation statements)

References 29 publications

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“…The primary endpoint of this study was rehospitalization due to worsening HF, and the secondary endpoints Kaplan-Meier analysis revealed that the incidence of rehospitalization was significantly lower in the TLV (+) group than in the TLV (−) group (log-rank test; p = 0.018) ( Figure 2). As shown in 18,19 In our study, 82.8% of the patients started TLV therapy from the first day of hospitalization, and TLV therapy reduced loop diuretics doses both at discharge and after 6 months, and it also prevented WRF development until 6 months…”

Section: Echocardiographysupporting

confidence: 68%

Efficacy of Tolvaptan in Elderly Patients with Heart Failure and Preserved Ejection Fraction

Suzuki

Murata

Tsujimoto

et al. 2019

Journal of Cardiovascular Emergencies

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Background: There is no known therapy with proven efficacy for improving clinical outcomes in elderly patients with heart failure (HF) and preserved ejection fraction (HFpEF). In this study, we aimed to evaluate the efficacy of tolvaptan (TLV) in elderly HFpEF patients. Methods: This retrospective observational study involved 100 consecutive elderly HFpEF patients hospitalized at the Nagoya Heart Center, Japan. Inclusion criteria were: (1) patients aged ≥75 years; (2) first hospitalization secondary to HF; (3) received medical therapy for HF, without invasive treatment; and (4) clinical follow-up for >6 months after discharge. The primary endpoint was rehospitalization due to worsening HF, and the secondary endpoint was worsening renal function (WRF) during hospitalization and at 6 months after discharge. Sixty background-matched HFpEF patients were divided into 2 groups: with TLV therapy (TLV (+), n = 29) and without TLV therapy (TLV (–), n = 31). In the TLV (+) group, TLV therapy was continued after discharge. Clinical outcomes of these patients were evaluated. Results: Bed rest period and length of hospital stay were significantly shorter in the TLV (+) group than in the TLV (−) group. The dose of loop diuretics, mean serum creatinine levels, and incidence of WRF development were significantly lower in the TLV (+) group. Incidence of rehospitalization was also significantly lower in the TLV (+) group (log-rank test; p = 0.018). The multivariate logistic regression analysis demonstrated that TLV therapy reduces the incidence of rehospitalization in elderly patients with HFpEF. Conclusions: TLV therapy reduced the bed rest period, length of hospital stay, and rate of rehospitalization without WRF in elderly HFpEF patients, suggesting that TLV could represent an effective therapy for this group of patients.

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Section: Echocardiographysupporting

confidence: 68%

Efficacy of Tolvaptan in Elderly Patients with Heart Failure and Preserved Ejection Fraction

Suzuki

Murata

Tsujimoto

et al. 2019

Journal of Cardiovascular Emergencies

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“…Major depression is a common comorbidity in patients with heart failure [30][31][32] and results in poor quality of life, an increased risk for hospitalization, and mortality. [33][34][35][36][37][38][39] A vast majority of heart failure patients have symptoms of depression and anxiety. 3) Depressive symptoms show a strong negative impact on quality of life.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Cognitive Behavioral Therapy for Heart Failure

et al. 2019

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Cognitive behavioral therapy has emerged as an important approach to alleviate the depression of patients with heart failure. However, the use of cognitive behavioral therapy for heart failure has not been well established. We conduct a systematic review and meta-analysis to evaluate the efficacy of cognitive behavioral therapy for alleviating depression for heart failure. PubMed, Embase, and the Cochrane Central Register of Controlled Trials are searched. Randomized controlled trials (RCTs) assessing the influence of cognitive behavioral therapy on heart failure are included. Two investigators independently have searched articles, extracted data, and assessed the quality of included studies. Meta-analysis is performed using the random-effect model. Eight RCTs involving 480 patients are included in the meta-analysis. Compared with control intervention for heart failure, cognitive behavioral therapy can substantially decrease depression scale (Std. MD = −0.27; 95% CI = −0.47 to −0.06; P = 0.01), but has no substantial influence on the quality of life (Std. MD = 0.21; 95% CI = −0.01 to 0.42; P = 0.06), self-care scores (Std. MD = 0.12; 95% CI = −0.18 to 0.42; P = 0.44), and 6-minute walk test distance (Std. MD = 0; 95% CI = −0.28 to 0.28; P = 0.99). Cognitive behavioral therapy is associated with significantly decreased depression scale, but with no substantial impact on the quality of life, self-care scores, and 6-minute walk test distance for heart failure.

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“…_ 1 ) T D $ F I G ] renal function is a key to better prognosis in HF patients. Table 2 summarizes the results of six long-term tolvaptan therapy studies, including four Japanese ones [27,[31][32][33][34]. Tolvaptan dose ranges were 4.9-9.8 mg/day in four Japanese studies, whereas two studies in other countries were performed at 30 mg/day [20,35].…”

Section: Renal Functionmentioning

confidence: 99%