Trial reportClinical research in cardiology : official journal of the German Cardiac Society2017
Early treatment with tolvaptan improves diuretic response in acute heart failure with renal dysfunction.
Trial report in Clinical research in cardiology : official journal of the German Cardiac Society, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it, 41 citations in OpenAlex.
- Pharmacological interventions for heart failure in people with chronic kidney disease.The Cochrane database of systematic reviews · 2020Pooled it
- Spot urinary sodium in acute decompensation of advanced heart failure and dilutional hyponatremia: insights from DRAIN trial.Clinical research in cardiology : official journal of the German Cardiac Society · 2020Trial
- Diuretic treatment in high-risk acute decompensation of advanced chronic heart failure-bolus intermittent vs. continuous infusion of furosemide: a randomized controlled trial.Clinical research in cardiology : official journal of the German Cardiac Society · 2020Trial
- Prognostic importance of sodium level trajectory in acute heart failure.Heart and vessels · 2017Trial
- Prognostic impact of the acute reactiveness to intravenous administration of tolvaptan sodium phosphate in patients with acute decompensated heart failure.European heart journal open · 2025Article
- Effects of door-to-tolvaptan time on short-term clinical outcome in patients with acute heart failure.ESC heart failure · 2023Observational
- Temporal trends in tolvaptan use after revision of national heart failure guidelines in Japan.Scientific reports · 2021Article
- Insights of Worsening Renal Function in Type 1 Cardiorenal Syndrome: From the Pathogenesis, Biomarkers to Treatment.Frontiers in cardiovascular medicine · 2021Review
- Congestion in heart failure: a contemporary look at physiology, diagnosis and treatment.Nature reviews. Cardiology · 2020Review
- Reappraisal on pharmacological and mechanical treatments of heart failure.Cardiovascular diabetology · 2020Review
- The relationship between the time until commencement of tolvaptan and the length of hospital stay in heart failure patients.Heart and vessels · 2018Observational
- Association between hypo- and hyperkalemia and outcome in acute heart failure patients: the role of medications.Clinical research in cardiology : official journal of the German Cardiac Society · 2018Observational
- Hyponatremia in Acute Heart Failure in Relation to Hematocrit Levels: Clinical Relevance and Prognostic Implication.Cardiorenal medicine · 2018Article
Corrections and comments
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Authors and funding
20 authors at 16 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPoor response to diuretics is associated with worse prognosis in patients with acute heart failure (AHF). We hypothesized that treatment with tolvaptan improves diuretic response in patients with AHF.
methodsWe performed a secondary analysis of the AQUAMARINE open-label randomized study in which a total of 217 AHF patients with renal impairment (eGFR < 60 mL/min/1.73 m
resultsThe mean time from patient presentation to randomization was 2.9 h. Patients with a better diuretic response showed greater relief of dyspnea and less worsening of renal function. Tolvaptan patients showed a significantly better diuretic response measured by diuretic response based both body weight [-1.16 (IQR -3.00 to -0.57) kg/40 mg vs. -0.51 (IQR -1.13 to -0.20) kg/40 mg; P < 0.001] and net fluid loss [2125.0 (IQR 1370.0-3856.3) mL/40 mg vs. 1296.3 (IQR 725.2-1726.5) mL/40 mg; P < 0.001]. Higher diastolic blood pressure and use of tolvaptan were independent predictors of a better diuretic response.
conclusionsBetter diuretic response was associated with greater dyspnea relief and less WRF. Early treatment with tolvaptan significantly improved diuretic response in AHF patients with renal dysfunction.
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