Role of tolvaptan in acute decompensated heart failure

Abstract

Acute decompensated heart failure accounts for more than 1 million hospitalizations in the USA every year. Currently, the most common treatment for symptom relief is the use of loop diuretics, despite recent concerns for potential adverse effects. With the growing understanding of the role of neurohormonal dysregulation in the pathophysiology of heart failure, there has been increasing interest in novel pharmacologic therapies targeting specific neurohormonal axes. Serum arginine vasopressin is a potent vasoconstrictor, as well as an antidiuretic, and serum concentrations are upregulated in heart failure. Tolvaptan, a vasopressin receptor antagonist, has been shown to improve diuresis and symptom relief without adversely affecting renal function, and may be a promising novel therapeutic agent in the growing population of patients with heart failure.

Keywords::

• heart failure
• pharmacology
• tolvaptan
• vasopressin

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.