PMID- 30255476
OWN - NLM
STAT- MEDLINE
DCOM- 20190617
LR  - 20190617
IS  - 1179-187X (Electronic)
IS  - 1175-3277 (Linking)
VI  - 19
IP  - 2
DP  - 2019 Apr
TI  - Short-Term Effects of Tolvaptan in Tricuspid Insufficiency Combined with Left 
      Heart Valve Replacement-Caused Volume-Overload Patients: Results of a Prospective 
      Pilot Study.
PG  - 211-218
LID - 10.1007/s40256-018-0304-1 [doi]
AB  - OBJECTIVES: Our objective was to explore the effects of tolvaptan as a new 
      therapeutic approach in patients with right heart failure with tricuspid 
      insufficiency (TI). METHODS: This prospective, multicenter, non-randomized 
      controlled pilot study enrolled patients (N = 40) with TI from the Shanghai Chest 
      Hospital and Shanghai Tongren Hospital who fulfilled inclusion criteria between 
      March 2015 and June 2016. Participants were assigned to receive either tolvaptan 
      combined with torasemide (n = 20) or torasemide monotherapy (n = 20; control 
      group). The primary endpoints were changes in patient weight and in tricuspid 
      annular plane systolic excursion (TAPSE) after 10 days of treatment. The 
      secondary endpoints included net fluid balance and cardiac functions before and 
      after medication from the first to the tenth day of treatment. Safety was 
      evaluated by monitoring adverse and serious adverse events. RESULTS: TAPSE 
      significantly increased in the tolvaptan group compared with the control group 
      after 10 days of medication (P = 0.029). Daily weight losses in the tolvaptan 
      group significantly increased as the time of treatment increased (time x group, 
      P = 0.022). Recovery to New York Heart Association (NYHA) grade I occurred 4 days 
      earlier in the tolvaptan group. In addition, the net fluid balance and median net 
      fluid balance were significantly higher in the tolvaptan group. Eight adverse 
      events and one serious adverse event were recorded in the tolvaptan group and 15 
      adverse events were recorded in the control group. CONCLUSIONS: Our results 
      indicate that tolvaptan might be a useful and safe drug to improve heart function 
      in patients with right heart failure with TI after left heart valve replacement. 
      CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov identifier no. NCT02644616.
FAU - Yuan, Fang
AU  - Yuan F
AD  - Department of Cardiology, Tongren Hospital, Shanghai Jiaotong University School 
      of Medicine, Shanghai, 200336, China.
FAU - Wu, Zhangmin
AU  - Wu Z
AD  - Department of Cardiology, Tongren Hospital, Shanghai Jiaotong University School 
      of Medicine, Shanghai, 200336, China.
FAU - Jiang, Li
AU  - Jiang L
AD  - Department of Cardiology, Tongren Hospital, Shanghai Jiaotong University School 
      of Medicine, Shanghai, 200336, China. jiangli@shtrhospital.com.
FAU - Zhou, Jun
AU  - Zhou J
AD  - Department of Cardiology, Tongren Hospital, Shanghai Jiaotong University School 
      of Medicine, Shanghai, 200336, China.
FAU - Xu, Lei
AU  - Xu L
AD  - Department of Cardiology, Shanghai Chest Hospital, Shanghai Jiaotong University, 
      Shanghai, 200030, China.
FAU - Liu, Hua
AU  - Liu H
AD  - Department of Cardiology, Shanghai Chest Hospital, Shanghai Jiaotong University, 
      Shanghai, 200030, China.
FAU - Ma, Lan
AU  - Ma L
AD  - Department of Ultrasound, Shanghai Chest Hospital, Shanghai Jiaotong University, 
      Shanghai, 200030, China.
FAU - Zhai, Zhenzhou
AU  - Zhai Z
AD  - Department of Emergency, Tongren Hospital, Shanghai Jiaotong University School of 
      Medicine, Shanghai, 200336, China.
FAU - Zhang, Junjie
AU  - Zhang J
AD  - Department of Emergency, Tongren Hospital, Shanghai Jiaotong University School of 
      Medicine, Shanghai, 200336, China.
LA  - eng
SI  - ClinicalTrials.gov/NCT02644616
GR  - 20162002/Acute Heart Failure Specialist/
PT  - Journal Article
PT  - Multicenter Study
PL  - New Zealand
TA  - Am J Cardiovasc Drugs
JT  - American journal of cardiovascular drugs : drugs, devices, and other 
      interventions
JID - 100967755
RN  - 0 (Antidiuretic Hormone Receptor Antagonists)
RN  - 0 (Diuretics)
RN  - 21G72T1950 (Tolvaptan)
RN  - W31X2H97FB (Torsemide)
SB  - IM
MH  - Aged
MH  - Antidiuretic Hormone Receptor Antagonists/adverse effects/*therapeutic use
MH  - Diuretics/adverse effects/therapeutic use
MH  - Female
MH  - Heart Valve Diseases/etiology/physiopathology
MH  - Heart Valve Prosthesis Implantation/*adverse effects
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Pilot Projects
MH  - Prospective Studies
MH  - Tolvaptan/adverse effects/*therapeutic use
MH  - Torsemide/adverse effects/therapeutic use
MH  - Treatment Outcome
MH  - Tricuspid Valve/drug effects/physiopathology
MH  - Tricuspid Valve Insufficiency/complications/*drug therapy/physiopathology
MH  - Water-Electrolyte Balance/drug effects
EDAT- 2018/09/27 06:00
MHDA- 2019/06/18 06:00
CRDT- 2018/09/27 06:00
PHST- 2018/09/27 06:00 [pubmed]
PHST- 2019/06/18 06:00 [medline]
PHST- 2018/09/27 06:00 [entrez]
AID - 10.1007/s40256-018-0304-1 [pii]
AID - 10.1007/s40256-018-0304-1 [doi]
PST - ppublish
SO  - Am J Cardiovasc Drugs. 2019 Apr;19(2):211-218. doi: 10.1007/s40256-018-0304-1.