Short-Term Effects of Tolvaptan in Patients With Acute Heart Failure and Volume Overload

Konstam, Marvin A.; Kiernan, Michael S.; Chandler, A. Bleakley; Dhingra, Ravi; Mody, Freny Vaghaiwalla; Eisen, Howard J.; Haught, W. Herbert; Wagoner, Lynne E.; Gupta, Divya; Patten, Richard D.; Gordon, Paul; Korr, Kenneth S.; Fileccia, Russell; Pressler, Susan J.; Gregory, Douglas; Wedge, Patricia; Dowling, Douglas; Romeling, Matthew; Konstam, Jeremy M.; Massaro, Joseph M.; Udelson, James E.

doi:10.1016/j.jacc.2016.12.035

Cited by 140 publications

(127 citation statements)

References 21 publications

Supporting

Mentioning

100

Contrasting

Unclassified

Order By: Relevance

“…Similarly, in a recently published TACTICS-HF study involving patients hospitalized for acute heart failure ( n = 257), randomization to 3 days of daily tolvaptan compared to placebo failed to show any difference in length of hospital stay, 30-day mortality, and 30-day re-hospitalization rates [41] . Similar results were found in the SECRET of CHF trial [42] . Patients with late-stage CKD often develop euvolemic or hypervolemic hyponatremia due to limited kidney function.…”

Section: Hyperkalemiasupporting

confidence: 88%

Acid-Base and Electrolyte Disorders in Patients with and without Chronic Kidney Disease: An Update

Dhondup¹,

Qian²

2017

Kidney Dis

View full text Add to dashboard Cite

Kidneys play a pivotal role in the maintenance and regulation of acid-base and electrolyte homeostasis, which is the prerequisite for numerous metabolic processes and organ functions in the human body. Chronic kidney diseases compromise the regulatory functions, resulting in alterations in electrolyte and acid-base balance that can be life-threatening. In this review, we discuss the renal regulations of electrolyte and acid-base balance and several common disorders including metabolic acidosis, alkalosis, dysnatremia, dyskalemia, and dysmagnesemia. Common disorders in chronic kidney disease are also discussed. The most recent and relevant advances on pathophysiology, clinical characteristics, diagnosis, and management of these conditions have been incorporated.

show abstract

Section: Hyperkalemiasupporting

confidence: 88%

Acid-Base and Electrolyte Disorders in Patients with and without Chronic Kidney Disease: An Update

Dhondup¹,

Qian²

2017

Kidney Dis

View full text Add to dashboard Cite

show abstract

“…35 Subsequently, smaller trials, which focused on the use of tolvaptan in patients with lower serum sodium levels in order to achieve short term decongestion, did not show significant improvement in symptoms or clinical outcomes, despite leading to greater weight and fluid loss. 36,37 …”

Section: Introductionmentioning

confidence: 99%

Diuretic Treatment in Heart Failure

2017

View full text Add to dashboard Cite

“…However, in more advanced stages of heart failure inappropriately high levels of arginine vasopressin contribute to plasma expansion and dilutional hyponatraemia. More recently, early use of tolvaptan and use in patients with diuretic resistance, renal dysfunction or hyponatraemia, did result in more weight loss, but no significant improvement in dyspnoea relief . Currently, vasopressin antagonists are only indicated in patients with severe hyponatraemia, and their widespread use might be limited by the high drug costs.…”

Section: Practical Use Of Diuretics In Acute Heart Failurementioning

confidence: 99%

The use of diuretics in heart failure with congestion — a position statement from the Heart Failure Association of the European Society of Cardiology

Mullens

Damman

Harjola

et al. 2019

European J of Heart Fail

746

697

View full text Add to dashboard Cite

The vast majority of acute heart failure episodes are characterized by increasing symptoms and signs of congestion with volume overload. The goal of therapy in those patients is the relief of congestion through achieving a state of euvolaemia, mainly through the use of diuretic therapy. The appropriate use of diuretics however remains challenging, especially when worsening renal function, diuretic resistance and electrolyte disturbances occur. This position paper focuses on the use of diuretics in heart failure with congestion. The manuscript addresses frequently encountered challenges, such as (i) evaluation of congestion and clinical euvolaemia, (ii) assessment of diuretic response/resistance in the treatment of acute heart failure, (iii) an approach towards stepped pharmacologic diuretic strategies, based upon diuretic response, and (iv) management of common electrolyte disturbances. Recommendations are made in line with available guidelines, evidence and expert opinion.

show abstract

Short-Term Effects of Tolvaptan in Patients With Acute Heart Failure and Volume Overload

Cited by 140 publications

References 21 publications

Acid-Base and Electrolyte Disorders in Patients with and without Chronic Kidney Disease: An Update

Acid-Base and Electrolyte Disorders in Patients with and without Chronic Kidney Disease: An Update

Diuretic Treatment in Heart Failure

The use of diuretics in heart failure with congestion — a position statement from the Heart Failure Association of the European Society of Cardiology

Contact Info

Product

Resources

About