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タカダ タクマ
TAKADA Takuma
髙田 卓磨 所属 医学研究科 医学研究科 (医学部医学科をご参照ください) 職種 非常勤講師 |
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| 論文種別 | 原著 |
| 言語種別 | 英語 |
| 査読の有無 | 査読あり |
| 表題 | Predictors of the diuretic response in acute decompensated heart failure patients with severe aortic stenosis: sub-analysis of the LOHAS registry. |
| 掲載誌名 | 正式名：Cardiovascular intervention and therapeutics 略 称：Cardiovasc Interv Ther ISSNコード：18684297/18684297 |
| 掲載区分 | 国外 |
| 巻・号・頁 | pp.online |
| 著者・共著者 | Takada Takuma†, Jujo Kentaro*, Abe Takuro, Shimazaki Kensuke, Nara Yugo, Hioki Hirofumi, Kawashima Hideyuki, Kataoka Akihisa, Nakashima Makoto, Yamamoto Masanori, Mizutani Kazuki, Izumo Masaki, Nakazawa Gaku, Kozuma Ken, Saito Katsumi, Watanabe Yusuke |
| 担当区分 | 筆頭著者 |
| 発行年月 | 2025/02 |
| 概要 | For severe aortic stenosis (AS) patients awaiting valve replacement, managing acute decompensated heart failure (ADHF) is crucial due to poor prognosis. The LOHAS registry evaluated the effect of tolvaptan in patients (mean age: 85 years) with severe AS and ADHF, demonstrating stable hemodynamics and sufficient diuresis. We investigated predictors of rapid successful decongestion. In the LOHAS study, eligible patients received tolvaptan (7.5 mg) on day 1 plus standard ADHF treatments. Patients were divided based on decongestion achievement on day 4. Of 59 enrolled, 35 (59%) achieved decongestion (decongestion group), and 24 (41%) remained congested (congestion group). Changes in body weight, renal function, and hemodynamics were comparable between groups over the first 4 days. However, the maximum inferior vena cava (IVC) diameter at admission was significantly larger in the decongestion group than the congestion group (12.6 ± 6.3 vs. 7.6 ± 4.8 mm, p = 0.007). ROC analysis revealed a cut-off of 11 mm for maximum IVC diameter to predict decongestion on day 4 (AUC: 0.73, 95% CI 0.58-0.88). In-hospital mortality was lower in the decongestion group (0% vs. 13%, p = 0.06). In conclusion, in this high-risk severe AS and ADHF population, adding tolvaptan to standard therapy may rapidly improve decompensation if patients have a sufficiently expanded IVC at admission. Maximum IVC diameter could predict successful decongestion with tolvaptan. |
| DOI | 10.1007/s12928-025-01100-1 |
| PMID | 39934604 |