Increased Urine Aquaporin-2 Relative to Plasma Arginine Vasopressin Is a Novel Marker of Response to Tolvaptan in Patients With Decompensated Heart Failure

Background:Preserved function of the renal collecting duct may be essential for response to the vasopressin V2receptor antagonist, tolvaptan (TLV), but the predictors of response to TLV are unknown.Methods and Results:Sixty consecutive patients with stage D decompensated heart failure (HF) who had r...

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Bibliographic Details
Published in:Circulation Journal 2014/08/25, Vol.78(9), pp.2240-2249
Main Authors: Imamura, Teruhiko, Kinugawa, Koichiro, Fujino, Takeo, Inaba, Toshiro, Maki, Hisataka, Hatano, Masaru, Yao, Atsushi, Komuro, Issei
Format: Article
Language:English
Subjects:
Adult
Aged
Antidiuretic Hormone Receptor Antagonists - administration & dosage
Aquaporin 2 - urine
Arginine Vasopressin - blood
Benzazepines - administration & dosage
Biomarkers - blood
Biomarkers - urine
Chronic kidney disease
Congestive heart failure
Diabetes insipidus
Disease-Free Survival
Diuretics
Female
Heart Failure - blood
Heart Failure - drug therapy
Heart Failure - metabolism
Heart Failure - urine
Humans
Male
Middle Aged
Survival Rate
Tolvaptan
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Summary:Background:Preserved function of the renal collecting duct may be essential for response to the vasopressin V2receptor antagonist, tolvaptan (TLV), but the predictors of response to TLV are unknown.Methods and Results:Sixty consecutive patients with stage D decompensated heart failure (HF) who had received TLV on a de novo basis were retrospectively enrolled (TLV(+) group). Among them, 41 patients were responders defined according to urine volume (UV) increase after TLV initiation. In the UV-defined responders, plasma arginine vasopressin (P-AVP) had a close correlation with urine aquaporin-2 (U-AQP2; 5.42±3.54 ng/ml; r=0.843, P
ISSN:1346-9843
1347-4820
DOI:10.1253/circj.CJ-14-0244