循環器ジャーナル65巻1号

2017年01月発行

特集 Clinical Scenarioによる急性心不全治療 Ⅳ．Clinical Scenario 2：体液過剰を伴う急性心不全

急性心不全治療におけるトルバプタンの使い方

著者： 鈴木聡¹ 竹石恭知¹

所属機関： ¹福島県立医科大学循環器・血液内科学講座

ページ範囲：P.72 - P.76

Point
・既存の利尿薬と異なり水利尿作用が主体であるトルバプタンは，心不全の予後不良因子である低ナトリウム患者に安全に使用できる．
・トルバプタンは体液貯留が顕著なClinical Scenario 2において，特に有用性が高いと考えられる．

参考文献

1) Binanay C, Califf RM, Hasselblad V, et al;ESCAPE Investigators and ESCAPE Study Coordinators:Evaluation study of congestive heart failure and pulmonary artery catheterization effectiveness:The ESCAPE trial. JAMA 294:1625-1633, 2005

2) Peacock WF, Costanzo MR, De Marco T, et al;ADHERE Scientific Advisory Committee and Investigators:Impact of intravenous loop diuretics on outcomes of patients hospitalized with acute decompensated heart failure:insights from the ADHERE registry. Cardiology 113:12-19, 2009

3) Sato N, Kajimoto K, Keida T, et al;ATTEND Investigators:Clinical features and outcome in hospitalized heart failure in Japan（from the ATTEND Registry). Circ J 77:944-951, 2013

4) Barsheshet A, Shotan A, Cohen E, et al:Predictors of long-term（4-year）mortality in elderly and young patients with acute heart failure. Eur J Heart Fail 12:833-840, 2010

5) Francis GS, Benedict C, Johnstone DE, et al:Comparison of neuroendocrine activation in patients with left ventricular dysfunction with and without congestive heart failure. A substudy of the Studies of Left Ventricular Dysfunction（SOLVD). Circulation 82:1724-1729, 1990

6) Gheorghiade M, Abraham WT, Albert NM, et al;OPTIMIZE-HF Investigators and Coordinators:Relationship between admission serum sodium concentration and clinical outcomes in patients hospitalized for heart failure:an analysis from the OPTIMIZE-HF registry. Eur Heart J 28:980-988, 2007

7) Sato N, Gheorghiade M, Kajimoto K, et al:Hyponatremia and in-hospital mortality in patients admitted for heart failure（from the ATTEND registry). Am J Cardiol 111:1019-1025, 2013

8) Gheorghiade M, Konstam MA, Burnett JC Jr, et al: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 297:1332-1343, 2007

9) Hayashi M, Tsutamoto T, Wada A, et al:Intravenous atrial natriuretic peptide prevents left ventricular remodeling in patients with first anterior acute myocardial infarction. J Am Coll Cardiol 37:1820-1826, 2001

10) Nomura F, Kurobe N, Mori Y, et al:Multicenter prospective investigation on efficacy and safety of carperitide as a first-line drug for acute heart failure syndrome with preserved blood pressure:COMPASS:Carperitide effects observed through monitoring dyspnea in acute decompensated heart failure study. Circ J 72:1777-1786, 2008

11) Hata N, Seino Y, Tsutamoto T, et al:Effects of carperitide on the long-term prognosis of patients with acute decompensated chronic heart failure:the PROTECT multicenter randomized controlled study. Circ J 72:1787-1793, 2008

12) Suzuki S, Yoshihisa A, Yamaki T, et al:Acute heart failure volume control multicenter randomized（AVCMA）trial:comparison of tolvaptan and carperitide. J Clin Pharmacol 53:1277-1285, 2013

receptor antagonist tolvaptan is effective in heart failure patients with reduced left ventricular systolic function and low blood pressure. Int Heart J 56:213-218, 2015

14) Goldsmith SR, Francis GS, Cowley AW Jr, et al:Increased plasma arginine vasopressin levels in patients with congestive heart failure. J Am Coll Cardiol 6:1385-1390, 1983

15) Mebazaa A, Gheorghiade M, Piña IL, et al:Practical recommendations for prehospital and early in-hospital management of patients presenting with acute heart failure syndromes. Crit Care Med 36:S129-S139, 2008

16) Imamura T, Kinugawa K, Shiga T, et al: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 77:397-404, 2013

17) Imamura T, Kinugawa K, Fujino T, et al:Increased urine aquaporin-2 relative to plasma arginine vasopressin is a novel marker of response to tolvaptan in patients with decompensated heart failure. Circ J 78:2240-2249, 2014

receptor antagonists is associated with a shorter hospital stay and reduction in in-hospital death in patients with decompensated heart failure. Heart Vessels [Epub ahead of print], 2015