Clinical Study on Tolvaptan in the Treatment of Diuretic-resistant Heart Failure Patients / 中国药房

ABSTRACT

OBJECTIVE:To evaluate clinical effect and safety of tolvalptan in the treatment of diuretic-resistant heart failure. METHODS:The clinical data of 21 inpatients with diuretic-resistant heart failure in cardiology department of the First Affiliated Hospital of Chongqing Medical University during Jan. 2014-Aug. 2016 were analyzed retrospectively.The heart failure improvement of 21 patients was not obvious after the treatment of a large dose of loop diuretics(furosemide and/or torasemide),and then the treatment was changed into tovalptan. Among them,19 patients were treated with Tovalptan tablets 7.5 mg orally,qd,and 2 pa-tients were treated with Tovalptan tablets 15 mg orally,qd,continuously until the patients discharged. The cardiac function,ede-ma,outcome and body weight,blood pressure,blood sodium,blood creatinine and blood NT-proBNP levels,the change of urine volume per unit time were compared among 21 patients before and after treatment. The occurrence of ADR was observed. RE-SULTSAfter treatment,cardiac function of 21 patients were improved significantly,edema and systolic blood pressure were de-creased significantly while blood sodium and urine volume per unit time were increased significantly,with statistical significance (P<0.05).There was no statistical significance in body weight,diastolic blood pressure,blood creatinine or blood NT-proBNP lev-els before and after treatment(P>0.05).Among 21 patients,one patient suffered from dry mouth;systolic blood pressure of 3 pa-tients decreased by 20 mmHg or above,compared to basic value;diastolic blood pressure of 4 patients decreased by 10 mmHg or above,compared to basic value. CONCLUSIONS:For diuretic-resistant patients,tolvaptan can increase urine volume,improve cardiac function and correct hyponatremia,besides it also lowers the systolic blood pressure.