イシダ　イツセイ   Ishida Itsusei   石田　一世    所属   医学部 医学科（東京女子医科大学病院）    職種   助教
言語種別	英語
発表タイトル	Good Response to Tolvaptan Shortens Hospitalization Period of Patients with Congestive Heart Failure
会議名	The 79th Annual Scientific Meeting of the Japanese Circulation Society
主催者	Japanese Circulation Society
学会区分	全国規模の学会
発表形式	ポスター掲示
講演区分	一般
発表者・共同発表者	◎HAMADA Kazuyuki, JUJO Kentaro, KIM Ahsung, ISHIDA Issei, SUZUKI Yuki, SAITO Katsumi, HAGIWARA Nobuhisa
発表年月日	2015/04/24
開催地 （都市, 国名）	Osaka, JAPAN
学会抄録	PROGRAM JCS 2015 213
概要	BACKGROUNDS: Tolvaptan has been gradually spread to use for congestive heart failure. However, the response to this aquaretic drug still is unpredictable.METHODS and RESULTS: Total of 92 consecutive patients hospitalized due to worsening of congestive heart failure was retrospectively analyzed. Responder was defined as peak daily fluid balance less than -500 mL/day, and baseline clinical backgrounds were compared between 76 responders and 16 non-responders. As results, daily urine volume and fluid balance were significantly different between the groups from day1-3. Non-responders showed no significant increase up to day5. Although total duration of tolvaptan administration was similar between the groups, time from administration to start of tolvaptan was significantly shorter in responders(1.0(0-4.0) vs. 3.5(0.3-5.8) days, p=0.05). In terms of baseline renal functions, serum creatinine, eGFR and BUN were significantly better in responders(1.1(0.7-1.6) vs. 1.5(1.0-2.9) mg/dL, p<0.01; 48(29-70) vs. 26(17-55) ml/min/1.73m2, p=0.01; 25(18-32) vs. 40(24-50) mg/dL, p<0.01, respectively). As for neurohumoral factors, only plasma renin activity was significantly lower in responders. Interestingly, all of baseline, minimum and maximum sodium concentration were significantly HIGHER in responders(baseline, 138(134-141) vs. 136(134-137) mEq/L, p=0.04). Finally, durations of CCU stay and total hospitalization were significantly shorter in responders(6.0(3.0-8.0) vs. 13(5.5-16) days, p=0.02; 15(11-24) vs. 22(15-41) days, p=0.05, respectively).CONCLUSION: Responders of tolvaptan had better renal functions and lower renin activity at baseline, and shortened hospitalization period.