PMID- 24949180
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20140620
LR  - 20220317
IS  - 1995-705X (Print)
IS  - 0976-5123 (Electronic)
IS  - 1995-705X (Linking)
VI  - 15
IP  - 1
DP  - 2014 Jan
TI  - Short term efficacy and safety of low dose tolvaptan in patients with acute 
      decompensated heart failure with hyponatremia: a prospective observational pilot 
      study from a single center in South India.
PG  - 1-5
LID - 10.4103/1995-705X.132136 [doi]
AB  - BACKGROUND: In acute decompensated heart failure (ADHF), diuretic use, the 
      mainstay therapy for congestion, is associated with electrolyte abnormalities and 
      worsening renal function. Vasopressin mediates fluid retention in heart failure. 
      In contrast to diuretics, the vasopressin antagonist tolvaptan may increase net 
      volume loss in heart failure without adversely affecting electrolytes and renal 
      function. Hyponatremia (serum sodium concentration, <135 mEq/L) is a predictor of 
      death among patients with heart failure. OBJECTIVE: We prospectively observed the 
      short term efficacy and safety of low dose (15 mg) tolvaptan in admitted patients 
      with hyponatremia and ADHF in Indian population. METHODOLOGY: A total of 40 
      patients with ADHF along with hyponatremia (<125 mEq/L) on standard therapy were 
      treated with 15 mg of tolvaptan at a single oral dose for 7 days. RESULTS: Serum 
      sodium concentrations increased significantly after treatment with tolvaptan from 
      baseline (P < 0.02). There was a significant improvement in symptoms and New York 
      Heart Association (NYHA) class after starting tolvaptan (P </= 0.05). Total 
      diuretic dose and mean body weight was reduced non-significantly at 7(th) day 
      from the baseline. Side-effects associated with tolvaptan included increased 
      thirst, dry mouth and increased urination. Few patients had worsening renal 
      function. However, several patients developed hypernatremia. CONCLUSION: In this 
      small observational study, tolvaptan initiation in patients with ADHF with 
      hyponatremia in addition to standard therapy may hold promise in improvement in 
      NYHA class and serum sodium. At the same time, we observed that serious adverse 
      events such as renal function deterioration and hypernatremia developed after 
      tolvaptan treatment, which needs to be addressed in future by randomized study 
      with larger sample size.
FAU - Patra, Soumya
AU  - Patra S
AD  - Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and 
      Research, Mysore Branch, K.R. Hospital Campus, Mysore, Karnataka, India.
FAU - Kumar, Basant
AU  - Kumar B
AD  - Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and 
      Research, Mysore Branch, K.R. Hospital Campus, Mysore, Karnataka, India.
FAU - Harlalka, Kaushal K
AU  - Harlalka KK
AD  - Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and 
      Research, Mysore Branch, K.R. Hospital Campus, Mysore, Karnataka, India.
FAU - Jain, Apoorva
AU  - Jain A
AD  - Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and 
      Research, Mysore Branch, K.R. Hospital Campus, Mysore, Karnataka, India.
FAU - Bhanuprakash, H M
AU  - Bhanuprakash HM
AD  - Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and 
      Research, Mysore Branch, K.R. Hospital Campus, Mysore, Karnataka, India.
FAU - Sadananda, K S
AU  - Sadananda KS
AD  - Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and 
      Research, Mysore Branch, K.R. Hospital Campus, Mysore, Karnataka, India.
FAU - Basappa, Harsha
AU  - Basappa H
AD  - Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and 
      Research, Mysore Branch, K.R. Hospital Campus, Mysore, Karnataka, India.
FAU - Santhosh, K
AU  - Santhosh K
AD  - Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and 
      Research, Mysore Branch, K.R. Hospital Campus, Mysore, Karnataka, India.
FAU - Rajith, K S
AU  - Rajith KS
AD  - Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and 
      Research, Mysore Branch, K.R. Hospital Campus, Mysore, Karnataka, India.
FAU - Bharathi, K S
AU  - Bharathi KS
AD  - Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and 
      Research, Mysore Branch, K.R. Hospital Campus, Mysore, Karnataka, India.
FAU - Manjunath, C N
AU  - Manjunath CN
AD  - Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and 
      Research, Mysore Branch, K.R. Hospital Campus, Mysore, Karnataka, India.
LA  - eng
PT  - Journal Article
PL  - India
TA  - Heart Views
JT  - Heart views : the official journal of the Gulf Heart Association
JID - 101316474
PMC - PMC4062982
OTO - NOTNLM
OT  - Acute decompensated heart failure
OT  - hyponatremia
OT  - tolvaptan
OT  - vasopressin antagonist
COIS- Conflict of Interest: None declared.
EDAT- 2014/06/21 06:00
MHDA- 2014/06/21 06:01
PMCR- 2014/01/01
CRDT- 2014/06/21 06:00
PHST- 2014/06/21 06:00 [entrez]
PHST- 2014/06/21 06:00 [pubmed]
PHST- 2014/06/21 06:01 [medline]
PHST- 2014/01/01 00:00 [pmc-release]
AID - HV-15-1 [pii]
AID - 10.4103/1995-705X.132136 [doi]
PST - ppublish
SO  - Heart Views. 2014 Jan;15(1):1-5. doi: 10.4103/1995-705X.132136.