Evidence map›Paper›PMID 32543020›Full record

Trial reportESC heart failure2020

Tolvaptan vs. furosemide-based diuretic regimens in patients hospitalized for heart failure with hyponatremia (AQUA-AHF).

Tien M H Ng, Luanda P Grazette, Michael W Fong, Andrew J Yoon, Mimi Lou, Allen Kuo, Rani Y Upadhyay, Emily E Han, Anilkumar Mehra, Uri Elkayam

Open access · goldAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in ESC heart failure, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed, 2 pooled it
0.9field-weighted citation impact, top 22% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

12 citing papers in PubMed, 2 syntheses or guidelines pooled it, 15 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Trial
  4. Trial
  5. Trial
  6. Decongestion Strategies in Acute Heart Failure.Current heart failure reports · 2026
    Review
  7. Review
  8. Importance of early use of tolvaptan in hyponatremic acutely decompensated heart failure patients, a retrospective study.The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology · 2025
    Article
  9. Article
  10. Article
  11. Review
  12. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 1 institution in 1 country.

Tien M H NgSchool of Pharmacy, University of Southern California, Los Angeles, CA, USA.ORCID 0000-0003-2251-8268
Luanda P GrazetteDivision of Cardiovascular Medicine, University of Southern California, Los Angeles, CA, USA.
Michael W FongDivision of Cardiovascular Medicine, University of Southern California, Los Angeles, CA, USA.
Andrew J YoonDivision of Cardiovascular Medicine, University of Southern California, Los Angeles, CA, USA.
Mimi LouSchool of Pharmacy, University of Southern California, Los Angeles, CA, USA.
Allen KuoDivision of Cardiovascular Medicine, University of Southern California, Los Angeles, CA, USA.
Rani Y UpadhyayDivision of Cardiovascular Medicine, University of Southern California, Los Angeles, CA, USA.
Emily E HanSchool of Pharmacy, University of Southern California, Los Angeles, CA, USA.
Anilkumar MehraDivision of Cardiovascular Medicine, University of Southern California, Los Angeles, CA, USA.
Uri ElkayamDivision of Cardiovascular Medicine, University of Southern California, Los Angeles, CA, USA.
University of Southern California · US

Funding

Otsuka America Pharmaceutical 20141519
6 · The paper itself

Abstract

aimsHyponatremia is associated with poorer outcomes and diuretic response in patients hospitalized for heart failure. This study compared a tolvaptan-based vs. furosemide-based diuretic regimen on short-term clinical responses in hyponatremic acute heart failure. METHODS AND

resultsProspective, randomized, open-label, parallel-group, single-centre study comparing oral tolvaptan vs. continuous infusion furosemide. Thirty-three subjects requiring hospitalization for acute congestive heart failure, and a serum sodium < 135 mmol/L, were randomized to tolvaptan 30 mg orally daily or furosemide 5 mg/h intravenously for initial 24 h, after which treatments could be escalated. Median daily dose throughout was tolvaptan 30 mg and furosemide 120 mg, with four subjects in each group requiring dose escalation. Urine output and net fluid balance were not different between groups at 24 h or subsequent time points up to 96 h. Changes in estimated glomerular filtration rate were comparable. Cystatin C improved at 24 h with tolvaptan compared with furosemide (-6.4 ± 11.8 vs. 4.1 ± 17.2% change, P = 0.036), but the effect was transient. No significant between group differences were seen for NT-proBNP, plasma renin activity, or urinary neutrophil gelatinase-associated lipocalin:Cr. Serum sodium, as well as copeptin levels, increased with tolvaptan compared with furosemide.

conclusionsOral tolvaptan was associated with similar, but not superior, diuresis compared with intravenous furosemide for acute heart failure with concomitant hyponatremia.

Indexed as

Heart FailureHyponatremiaAntidiuretic Hormone Receptor AntagonistsBenzazepinesDiureticsFurosemideHumansProspective StudiesTolvaptanAntidiuretic Hormone Receptor AntagonistsBenzazepinesDiureticsFurosemideTolvaptanDiureticsHeart failureHyponatremiaVasopressin

Identifiers

PMID32543020
PMCPMC7373913
OpenAlexW3034260459

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.