Importance of early use of tolvaptan in hyponatremic acutely decompensated heart failure patients, a retrospective study
Abstract Background Hyponatremia is one of the complicating findings in acute decompensated heart failure. Decrease in cardiac output and systemic blood pressure triggers activation of renin–angiotensin–aldosterone system, antidiuretic hormone, and norepinephrine due to the perceived hypovolemia. Fl...
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| Format: | Article |
| Language: | English |
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SpringerOpen
2025-01-01
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| Series: | The Egyptian Heart Journal |
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| Online Access: | https://doi.org/10.1186/s43044-024-00603-1 |
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| author | Rarsari Soerarso Emir Yonas Silfi Pauline Sirait Dian Yaniarti Hasanah Sunu Budhi Raharjo Bambang Budi Siswanto Maarten J. Cramer Pim van der Harst Marish I. F. J. Oerlemans |
| author_facet | Rarsari Soerarso Emir Yonas Silfi Pauline Sirait Dian Yaniarti Hasanah Sunu Budhi Raharjo Bambang Budi Siswanto Maarten J. Cramer Pim van der Harst Marish I. F. J. Oerlemans |
| author_sort | Rarsari Soerarso |
| collection | DOAJ |
| description | Abstract Background Hyponatremia is one of the complicating findings in acute decompensated heart failure. Decrease in cardiac output and systemic blood pressure triggers activation of renin–angiotensin–aldosterone system, antidiuretic hormone, and norepinephrine due to the perceived hypovolemia. Fluid-overloaded heart failure patients are commonly treated with loop diuretics, acutely decompensated heart failure patients tend to be less responsive to conventional oral doses of a loop diuretic, while other different diuretics could work in different part of nephron circulation system. In this study, we aim to further examine the role of tolvaptan, a vasopressin receptor antagonist, in the treatment of hyponatremia secondary to acutely decompensated heart failure. Results A total of 71 patients with hyponatremia secondary to ADHF were included, and all patients were given tolvaptan. 37 patients were administered tolvaptan early (up until 5 th day of admission). 34 patients received tolvaptan after 5 th day of admission mean administration as 6.86 th day, and median administration was 5 th day. Analysis showed lower length of stay in patients receiving early administration of tolvaptan compared to late administration (8.86 ± 5.06 vs 18.5 ± 9.05 p0.001, respectively). Patients with early initiation of tolvaptan also achieved a larger net increase in sodium levels at discharge compared to admission (6.46 ± 6.69 vs 3.68 ± 4.70 p0.048, respectively). Conclusions Early administration of tolvaptan in treating hyponatremia in acutely decompensated heart failure patients is associated with a lower length of hospitalization and a higher increase in serum sodium of patients in hyponatremic ADHF patients. |
| format | Article |
| id | doaj-art-3ed3022077884371a609d440bacc204b |
| institution | Kabale University |
| issn | 2090-911X |
| language | English |
| publishDate | 2025-01-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | The Egyptian Heart Journal |
| spelling | doaj-art-3ed3022077884371a609d440bacc204b2025-01-19T12:28:20ZengSpringerOpenThe Egyptian Heart Journal2090-911X2025-01-017711710.1186/s43044-024-00603-1Importance of early use of tolvaptan in hyponatremic acutely decompensated heart failure patients, a retrospective studyRarsari Soerarso0Emir Yonas1Silfi Pauline Sirait2Dian Yaniarti Hasanah3Sunu Budhi Raharjo4Bambang Budi Siswanto5Maarten J. Cramer6Pim van der Harst7Marish I. F. J. Oerlemans8Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Indonesia, National Cardiovascular Center Harapan KitaDepartment of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Indonesia, National Cardiovascular Center Harapan KitaDepartment of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Indonesia, National Cardiovascular Center Harapan KitaDepartment of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Indonesia, National Cardiovascular Center Harapan KitaDepartment of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Indonesia, National Cardiovascular Center Harapan KitaDepartment of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Indonesia, National Cardiovascular Center Harapan KitaDepartment of Cardiology, Division of Heart & Lungs, University Medical Center Utrecht, University of UtrechtDepartment of Cardiology, Division of Heart & Lungs, University Medical Center Utrecht, University of UtrechtDepartment of Cardiology, Division of Heart & Lungs, University Medical Center Utrecht, University of UtrechtAbstract Background Hyponatremia is one of the complicating findings in acute decompensated heart failure. Decrease in cardiac output and systemic blood pressure triggers activation of renin–angiotensin–aldosterone system, antidiuretic hormone, and norepinephrine due to the perceived hypovolemia. Fluid-overloaded heart failure patients are commonly treated with loop diuretics, acutely decompensated heart failure patients tend to be less responsive to conventional oral doses of a loop diuretic, while other different diuretics could work in different part of nephron circulation system. In this study, we aim to further examine the role of tolvaptan, a vasopressin receptor antagonist, in the treatment of hyponatremia secondary to acutely decompensated heart failure. Results A total of 71 patients with hyponatremia secondary to ADHF were included, and all patients were given tolvaptan. 37 patients were administered tolvaptan early (up until 5 th day of admission). 34 patients received tolvaptan after 5 th day of admission mean administration as 6.86 th day, and median administration was 5 th day. Analysis showed lower length of stay in patients receiving early administration of tolvaptan compared to late administration (8.86 ± 5.06 vs 18.5 ± 9.05 p0.001, respectively). Patients with early initiation of tolvaptan also achieved a larger net increase in sodium levels at discharge compared to admission (6.46 ± 6.69 vs 3.68 ± 4.70 p0.048, respectively). Conclusions Early administration of tolvaptan in treating hyponatremia in acutely decompensated heart failure patients is associated with a lower length of hospitalization and a higher increase in serum sodium of patients in hyponatremic ADHF patients.https://doi.org/10.1186/s43044-024-00603-1Acute decompensated heart failureHyponatremiaLength of stayTolvaptan |
| spellingShingle | Rarsari Soerarso Emir Yonas Silfi Pauline Sirait Dian Yaniarti Hasanah Sunu Budhi Raharjo Bambang Budi Siswanto Maarten J. Cramer Pim van der Harst Marish I. F. J. Oerlemans Importance of early use of tolvaptan in hyponatremic acutely decompensated heart failure patients, a retrospective study The Egyptian Heart Journal Acute decompensated heart failure Hyponatremia Length of stay Tolvaptan |
| title | Importance of early use of tolvaptan in hyponatremic acutely decompensated heart failure patients, a retrospective study |
| title_full | Importance of early use of tolvaptan in hyponatremic acutely decompensated heart failure patients, a retrospective study |
| title_fullStr | Importance of early use of tolvaptan in hyponatremic acutely decompensated heart failure patients, a retrospective study |
| title_full_unstemmed | Importance of early use of tolvaptan in hyponatremic acutely decompensated heart failure patients, a retrospective study |
| title_short | Importance of early use of tolvaptan in hyponatremic acutely decompensated heart failure patients, a retrospective study |
| title_sort | importance of early use of tolvaptan in hyponatremic acutely decompensated heart failure patients a retrospective study |
| topic | Acute decompensated heart failure Hyponatremia Length of stay Tolvaptan |
| url | https://doi.org/10.1186/s43044-024-00603-1 |
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