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Erschienen in: Heart and Vessels 3/2019

26.09.2018 | Original Article

Different diuretic properties between tolvaptan and furosemide in congestive heart failure patients with diuretic resistance and renal impairment: a subanalysis of the K-STAR

verfasst von: Yuki Ikeda, Takayuki Inomata, Keisuke Kida, Yugo Shibagaki, Naoki Sato, Tohru Izumi, Junya Ako, Kanagawa Aquaresis Investigators

Erschienen in: Heart and Vessels | Ausgabe 3/2019

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Abstract

We attempted to identify the difference in diuretic properties between tolvaptan (TLV) and furosemide (FUR) in congestive heart failure (CHF) patients with loop diuretic resistance and renal impairment. We investigated 81 CHF patients with loop diuretic treatment and renal impairment included in t he Kanagawa Aquaresis Investigators Trial of Tolvaptan on Heart Failure Patients with Renal Impairment (K-STAR). Predictive baseline factors and their changes during treatment periods were analyzed for correlation with percentage change in urine volume (%ΔUV) after additive introduction of TLV or increasing doses of FUR. Higher urine osmolality at baseline (β = 0.355; p = 0.033) in the TLV group and a lower ratio of blood urea nitrogen to serum creatinine (BUN/Cr, β = − 0.405; p = 0.020) in the FUR group were predictive of higher %ΔUV. Higher Δfree-water clearance (β = 0.667; p < 0.0001) in the TLV group, and higher %ΔBUN/Cr (β = 0.344; p = 0.030), higher %Δurine sodium concentration (β = 0.337; p = 0.037), and lower %Δstroke volume (β = − 0.390; p = 0.017) in the FUR group were correlated with %ΔUV. In conclusion, baseline urine osmolality and change in free-water clearance with additive introduction of TLV and a changing ratio of BUN/Cr with increasing doses of FUR were identified as key clinical parameters related to diuretic response.
Trial registration UMIN000009201.
Literatur
1.
Zurück zum Zitat Cody RJ (1993) Clinical trials of diuretic therapy in heart failure: research directions and clinical considerations. J Am Coll Cardiol 22:165a–171aCrossRefPubMed Cody RJ (1993) Clinical trials of diuretic therapy in heart failure: research directions and clinical considerations. J Am Coll Cardiol 22:165a–171aCrossRefPubMed
2.
Zurück zum Zitat Leto L, Aspromonte N, Feola M (2014) Efficacy and safety of loop diuretic therapy in acute decompensated heart failure: a clinical review. Heart Fail Rev 19:237–246CrossRefPubMed Leto L, Aspromonte N, Feola M (2014) Efficacy and safety of loop diuretic therapy in acute decompensated heart failure: a clinical review. Heart Fail Rev 19:237–246CrossRefPubMed
3.
Zurück zum Zitat Hasselblad V, Gattis Stough W, Shah MR, Lokhnygina Y, O'Connor CM, Califf RM, Adams KF Jr (2007) Relation between dose of loop diuretics and outcomes in a heart failure population: results of the ESCAPE trial. Eur J Heart Fail 9:1064–1069CrossRefPubMedPubMedCentral Hasselblad V, Gattis Stough W, Shah MR, Lokhnygina Y, O'Connor CM, Califf RM, Adams KF Jr (2007) Relation between dose of loop diuretics and outcomes in a heart failure population: results of the ESCAPE trial. Eur J Heart Fail 9:1064–1069CrossRefPubMedPubMedCentral
4.
Zurück zum Zitat Valente MA, Voors AA, Damman K, Van Veldhuisen DJ, Massie BM, O'Connor CM, Metra M, Ponikowski P, Teerlink JR, Cotter G, Davison B, Cleland JG, Givertz MM, Bloomfield DM, Fiuzat M, Dittrich HC, Hillege HL (2014) Diuretic response in acute heart failure: clinical characteristics and prognostic significance. Eur Heart J 35:1284–1293CrossRefPubMed Valente MA, Voors AA, Damman K, Van Veldhuisen DJ, Massie BM, O'Connor CM, Metra M, Ponikowski P, Teerlink JR, Cotter G, Davison B, Cleland JG, Givertz MM, Bloomfield DM, Fiuzat M, Dittrich HC, Hillege HL (2014) Diuretic response in acute heart failure: clinical characteristics and prognostic significance. Eur Heart J 35:1284–1293CrossRefPubMed
5.
Zurück zum Zitat ter Maaten JM, Dunning AM, Valente MA, Damman K, Ezekowitz JA, Califf RM, Starling RC, van der Meer P, O'Connor CM, Schulte PJ, Testani JM, Hernandez AF, Tang WH, Voors AA (2015) Diuretic response in acute heart failure—an analysis from ASCEND-HF. Am Heart J 170:313–321CrossRefPubMed ter Maaten JM, Dunning AM, Valente MA, Damman K, Ezekowitz JA, Califf RM, Starling RC, van der Meer P, O'Connor CM, Schulte PJ, Testani JM, Hernandez AF, Tang WH, Voors AA (2015) Diuretic response in acute heart failure—an analysis from ASCEND-HF. Am Heart J 170:313–321CrossRefPubMed
6.
Zurück zum Zitat Voors AA, Davison BA, Teerlink JR, Felker GM, Cotter G, Filippatos G, Greenberg BH, Pang PS, Levin B, Hua TA, Severin T, Ponikowski P, Metra M, Investigators RELAX-AHF (2014) Diuretic response in patients with acute decompensated heart failure: characteristics and clinical outcome—an analysis from RELAX-AHF. Eur J Heart Fail 16:1230–1240CrossRefPubMedPubMedCentral Voors AA, Davison BA, Teerlink JR, Felker GM, Cotter G, Filippatos G, Greenberg BH, Pang PS, Levin B, Hua TA, Severin T, Ponikowski P, Metra M, Investigators RELAX-AHF (2014) Diuretic response in patients with acute decompensated heart failure: characteristics and clinical outcome—an analysis from RELAX-AHF. Eur J Heart Fail 16:1230–1240CrossRefPubMedPubMedCentral
7.
Zurück zum Zitat ter Maaten JM, Valente MA, Damman K, Hillege HL, Navis G, Voors AA (2015) Diuretic response in acute heart failure—pathophysiology, evaluation, and therapy. Nat Rev Cardiol 12:184–192CrossRefPubMed ter Maaten JM, Valente MA, Damman K, Hillege HL, Navis G, Voors AA (2015) Diuretic response in acute heart failure—pathophysiology, evaluation, and therapy. Nat Rev Cardiol 12:184–192CrossRefPubMed
8.
9.
Zurück zum Zitat Doggrell SA (2004) Tolvaptan (Otsuka). Curr Opin Investig Drugs 5:977–983PubMed Doggrell SA (2004) Tolvaptan (Otsuka). Curr Opin Investig Drugs 5:977–983PubMed
10.
Zurück zum Zitat Gheorghiade M, Konstam MA, Burnett JC Jr, Grinfeld L, Maggioni AP, Swedberg K, Udelson JE, Zannad F, Cook T, Ouyang J, Zimmer C, Orlandi C (2007) Efficacy of Vasopressin Antagonism in Heart Failure Outcome Study With Tolvaptan (EVEREST) Investigators Short-term clinical effects of tolvaptan, an oral vasopressin antagonist, in patients hospitalized for heart failure: the EVEREST Clinical Status Trials. JAMA 297:1332–1343CrossRefPubMed Gheorghiade M, Konstam MA, Burnett JC Jr, Grinfeld L, Maggioni AP, Swedberg K, Udelson JE, Zannad F, Cook T, Ouyang J, Zimmer C, Orlandi C (2007) Efficacy of Vasopressin Antagonism in Heart Failure Outcome Study With Tolvaptan (EVEREST) Investigators Short-term clinical effects of tolvaptan, an oral vasopressin antagonist, in patients hospitalized for heart failure: the EVEREST Clinical Status Trials. JAMA 297:1332–1343CrossRefPubMed
11.
Zurück zum Zitat Inomata T, Ikeda Y, Kida K, Shibagaki Y, Sato N, Kumagai Y, Shinagawa H, Ako J, Izumi T, Investigators Kanagawa Aquaresis (2017) Effects of additive tolvaptan vs. increased furosemide on heart failure with diuretic resistance and renal impairment—results from the K-STAR study. Circ J 82:159–167CrossRefPubMed Inomata T, Ikeda Y, Kida K, Shibagaki Y, Sato N, Kumagai Y, Shinagawa H, Ako J, Izumi T, Investigators Kanagawa Aquaresis (2017) Effects of additive tolvaptan vs. increased furosemide on heart failure with diuretic resistance and renal impairment—results from the K-STAR study. Circ J 82:159–167CrossRefPubMed
12.
Zurück zum Zitat Testani JM, Brisco MA, Turner JM, Spatz ES, Bellumkonda L, Parikh CR, Tang WH (2014) Loop diuretic efficiency: a metric of diuretic responsiveness with prognostic importance in acute decompensated heart failure. Circ Heart Fail 7:261–270CrossRefPubMed Testani JM, Brisco MA, Turner JM, Spatz ES, Bellumkonda L, Parikh CR, Tang WH (2014) Loop diuretic efficiency: a metric of diuretic responsiveness with prognostic importance in acute decompensated heart failure. Circ Heart Fail 7:261–270CrossRefPubMed
13.
Zurück zum Zitat Imamura T, Kinugawa K, Shiga T, Kato N, Muraoka H, Minatsuki S, Inaba T, Maki H, Hatano M, Yao A, Kyo S, Nagai R (2013) Novel criteria of urine osmolality effectively predict response to tolvaptan in decompensated heart failure patients—association between non-responders and chronic kidney disease. Circ J 77:397–404CrossRefPubMed Imamura T, Kinugawa K, Shiga T, Kato N, Muraoka H, Minatsuki S, Inaba T, Maki H, Hatano M, Yao A, Kyo S, Nagai R (2013) Novel criteria of urine osmolality effectively predict response to tolvaptan in decompensated heart failure patients—association between non-responders and chronic kidney disease. Circ J 77:397–404CrossRefPubMed
14.
Zurück zum Zitat Okayama D, Suzuki T, Shiga T, Minami Y, Tsuruoka S, Hagiwara N (2015) Blood urea nitrogen/creatinine ratio and response to tolvaptan in patients with decompensated heart failure: a retrospective analysis. Am J Cardiovasc Drugs 15:289–293CrossRefPubMed Okayama D, Suzuki T, Shiga T, Minami Y, Tsuruoka S, Hagiwara N (2015) Blood urea nitrogen/creatinine ratio and response to tolvaptan in patients with decompensated heart failure: a retrospective analysis. Am J Cardiovasc Drugs 15:289–293CrossRefPubMed
15.
Zurück zum Zitat Lindenfeld J, Schrier RW (2011) Blood urea nitrogen a marker for adverse effects of loop diuretics? J Am Coll Cardiol 58:383–385CrossRefPubMed Lindenfeld J, Schrier RW (2011) Blood urea nitrogen a marker for adverse effects of loop diuretics? J Am Coll Cardiol 58:383–385CrossRefPubMed
16.
Zurück zum Zitat Miyazaki T, Fujiki H, Yamamura Y, Nakamura S, Mori T (2007) Tolvaptan, an orally active vasopressin V(2)-receptor antagonist—pharmacology and clinical trials. Cardiovasc Drug Rev 25:1–13CrossRefPubMed Miyazaki T, Fujiki H, Yamamura Y, Nakamura S, Mori T (2007) Tolvaptan, an orally active vasopressin V(2)-receptor antagonist—pharmacology and clinical trials. Cardiovasc Drug Rev 25:1–13CrossRefPubMed
17.
Zurück zum Zitat Ambrosy A, Goldsmith SR, Gheorghiade M (2011) Tolvaptan for the treatment of heart failure: a review of the literature. Expert Opin Pharmacother 12:961–976CrossRefPubMed Ambrosy A, Goldsmith SR, Gheorghiade M (2011) Tolvaptan for the treatment of heart failure: a review of the literature. Expert Opin Pharmacother 12:961–976CrossRefPubMed
18.
Zurück zum Zitat Ellison DH (2001) Diuretic therapy and resistance in congestive heart failure. Cardiology 96:132–143CrossRefPubMed Ellison DH (2001) Diuretic therapy and resistance in congestive heart failure. Cardiology 96:132–143CrossRefPubMed
19.
Zurück zum Zitat Konstam MA, Gheorghiade M, Burnett JC Jr, Grinfeld L, Maggioni AP, Swedberg K, Udelson JE, Zannad F, Cook T, Ouyang J, Zimmer C, Orlandi C, Efficacy of Vasopressin Antagonism in Heart Failure Outcome Study With Tolvaptan (EVEREST) Investigators (2007) Effects of oral tolvaptan in patients hospitalized for worsening heart failure: the EVEREST Outcome Trial. JAMA 297:1319–1331CrossRefPubMed Konstam MA, Gheorghiade M, Burnett JC Jr, Grinfeld L, Maggioni AP, Swedberg K, Udelson JE, Zannad F, Cook T, Ouyang J, Zimmer C, Orlandi C, Efficacy of Vasopressin Antagonism in Heart Failure Outcome Study With Tolvaptan (EVEREST) Investigators (2007) Effects of oral tolvaptan in patients hospitalized for worsening heart failure: the EVEREST Outcome Trial. JAMA 297:1319–1331CrossRefPubMed
Metadaten
Titel
Different diuretic properties between tolvaptan and furosemide in congestive heart failure patients with diuretic resistance and renal impairment: a subanalysis of the K-STAR
verfasst von
Yuki Ikeda
Takayuki Inomata
Keisuke Kida
Yugo Shibagaki
Naoki Sato
Tohru Izumi
Junya Ako
Kanagawa Aquaresis Investigators
Publikationsdatum
26.09.2018
Verlag
Springer Japan
Erschienen in
Heart and Vessels / Ausgabe 3/2019
Print ISSN: 0910-8327
Elektronische ISSN: 1615-2573
DOI
https://doi.org/10.1007/s00380-018-1270-x

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