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Good response to tolvaptan shortens hospitalization in patients with congestive heart failure

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A Correction to this article was published on 12 December 2017

This article has been updated

Abstract

Tolvaptan has been gradually spread to use as a potent diuretic for congestive heart failure in the limited country. However, the response to this aquaretic drug still is unpredictable. A total of 92 patients urgently hospitalized due to congestive heart failure and treated with tolvaptan in addition to standard treatment was retrospectively analyzed. Responder of tolvaptan treatment was defined as a patient with peak negative fluid balance greater than 500 mL/day, and clinical profiles were compared between 76 responders and 16 non-responders. Responders started to increase daily urine volume (UV) from Day 1 through Day 3. In contrast, non-responders showed no significant increase in daily UV from the baseline up to Day 5. Time between admission and tolvaptan administration was shorter in responders, even without statistical significance (3.3 vs. 4.6 days, p = 0.053). Multivariate analysis revealed that blood urea nitrogen (BUN) [cutoff: 34 mg/dL, odds ratio (OR) 9.0, 95% confidence interval (CI) 1.42–57.3, p < 0.01] and plasma renin activity (PRA) (cutoff: 4.7 ng/mL/h, OR 6.1, 95% CI 1.01–36.4, p < 0.01) at baseline were independent predictors for tolvaptan responsiveness. It suggests that renal perfusion may affect tolvaptan-induced UV. Finally, durations of stay in intensive care unit and total hospitalization were significantly shorter in responders (median: 6.0 vs. 13.0 days, p = 0.022; 15.0 vs. 25.0 days, p = 0.016, respectively). Responders of tolvaptan have lower BUN and renin activity at baseline, and shorten hospitalization period.

Trial Registration

The study was registered at University Hospital Medical Information Network Clinical Trials Registry (UMIN-CTR) with the identifier UMIN000023594. https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000024988

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Change history

  • 12 December 2017

    In the original publication of the article, the values of blood urea nitrogen (BUN) and plasma renin activity (PRA) have been published incorrectly and the corrected values are as follows.

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Acknowledgements

We would like to thank Editage (www.editage.jp) for English language editing.

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Authors and Affiliations

  1. Department of Cardiology, Tokyo Women’s Medical University, 8-1 Kawadacho, Shinjuku-ku, Tokyo, 162-0054, Japan

    Tomohito Kogure, Kentaro Jujo, Kazuyuki Hamada & Nobuhisa Hagiwara

  2. Department of Cardiology, Nishiarai Heart Center Hospital, Tokyo, Japan

    Katsumi Saito

Authors
  1. Tomohito Kogure
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  2. Kentaro Jujo
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  3. Kazuyuki Hamada
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  4. Katsumi Saito
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  5. Nobuhisa Hagiwara
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Corresponding author

Correspondence to Kentaro Jujo.

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Conflict of interest

This study was not financially supported from any company, grant or fund, and all authors have no conflict of interest.

Additional information

The original version of this article was revised: The values of blood urea nitrogen (BUN) and plasma renin activity (PRA) have been corrected in this article.

A correction to this article is available online at https://doi.org/10.1007/s00380-017-1102-4.

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Kogure, T., Jujo, K., Hamada, K. et al. Good response to tolvaptan shortens hospitalization in patients with congestive heart failure. Heart Vessels 33, 374–383 (2018). https://doi.org/10.1007/s00380-017-1072-6

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  • DOI: https://doi.org/10.1007/s00380-017-1072-6

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