ISHIDA Issei    Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine    Position   Assistant Professor
Language	English
Title	Good Response to Tolvaptan Shortens Hospitalization Period of Patients with Congestive Heart Failure
Conference	The 79th Annual Scientific Meeting of the Japanese Circulation Society
Promoters	Japanese Circulation Society
Conference Type	Nationwide Conferences
Presentation Type	Poster notice
Lecture Type	General
Publisher and common publisher	◎HAMADA Kazuyuki, JUJO Kentaro, KIM Ahsung, ISHIDA Issei, SUZUKI Yuki, SAITO Katsumi, HAGIWARA Nobuhisa
Date	2015/04/24
Venue (city and name of the country)	Osaka, JAPAN
Society abstract	PROGRAM JCS 2015 213
Summary	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.