所属 医学部 医学科（東京女子医科大学病院） 職種 助教
|発表タイトル||Comparison of Decongestion Effect between Single and Divided-dose Administration of Tolvaptan in Acute Heart Failure|
|会議名||The 81st Annual Scientific Meeting of the Japanese Circulation Society (JCS2017)|
|主催者||Japanese Circulation Society|
|発表者・共同発表者||◎KIKUCHI Yasuhiro, JUJO Kentaro, SHIMAZAKI Kensuke, HARUKI Shintaro, ITANI Ryosuke, ARASHI Hiroyuki, SEKIGUCHI Haruki|
|学会抄録||PROGRAM JCS 2017 334|
|概要||BACKGROUNDS: Tolvaptan is generally administered once a day to patients with congestive heart failure (CHF), even it has a short half-life of 6-12 hours. The relationship between the frequency of daily administration of tolvaptan and the urine volume (UV) in acutely decompensated CHF patients is totally unclear.
METHODS: This observational study included 49 consecutive patients who were urgently hospitalized due to worsening of CHF, and were treated with total of 7.5 mg daily tolvaptan. They were divided into two groups as single (QD group: 22 patients) and twice (BID group: 27 patients) administration of tolvaptan.
RESULTS: Prehospital medications and 5-day total furosemide dose were similar between QD and BID groups. However, BID group showed a sustained increase in daily UV through 5 days after tolvaptan initiation, compared to baseline. In contrast, QD group achieved UV increase in only first 2 days after the initiation. As results, 5-day total increase in UV from baseline was significantly higher in BID group. Hemodynamics, decongestion degrees or renal functions were similarly changed during 5 days between the groups. However, daily furosemide dose at discharge was significantly higher in QD group (51 vs. 35 mg/day,p=0.037), and cardiovascular death was significantly lower in BID group (Log-rank: p=0.042).
CONCLUSIONS: Divided-dose administration of tolvaptan may give sustainable fluid excretion to decompensated CHF patients.