Acute heart failure volume control multicenter randomized (AVCMA) trial: comparison of tolvaptan and carperitide.
Acute heart failure volume control multicenter randomized (AVCMA) trial: comparison of tolvaptan and carperitide.
复制标题
急性心力衰竭控制多中心随机（AVCMA）试验：Tolvaptan和Carperitide的比较。
DOI：
10.1002/jcph.197
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发表时间：
2013-12
影响因子：
2.9
通讯作者：
Takeishi, Yasuchika
中科院分区：
文献类型：
--
作者：
Suzuki, Satoshi;Yoshihisa, Akiomi;Yamaki, Takayoshi;Sugimoto, Koichi;Kunii, Hiroyuki;Nakazato, Kazuhiko;Abe, Yukihiko;Saito, Tomiyoshi;Ohwada, Takayuki;Suzuki, Hitoshi;Saitoh, Shu-ichi;Kubota, Isao;Takeishi, Yasuchika
急性失代偿性心力衰竭（ADHF）是一种常见且高度病态的心血管疾病。利尿是减轻充血症状的主要疗法。然而，大多数利尿剂引起低钠血症，这是ADHF患者预后恶化的因素。本研究的目的是检查托伐普坦的有效性和安全性，托伐普坦是一种选择性加压素V2受体拮抗剂，与卡培立肽相比，可产生水排泄而不改变钠排泄。入组了109例住院ADHF患者，并随机分配至托伐普坦或卡培立肽治疗组。两组治疗后主观症状和血浆BNP水平改善情况相似。托伐普坦组的尿量显著较高（P <0.05），但托伐普坦组的饮水量也较高（P <0.05）。治疗后卡培立肽组的血压显著低于托伐普坦组（P <0.05）。在托伐普坦组中观察到较少的不良事件，如心力衰竭恶化和需要停药的低血压（P = 0.027）。托伐普坦的平均药费低于卡培立肽（P < .001）。与卡培立肽相比，托伐普坦可能是治疗ADHF的一种新的有前途的药物。
Acute decompensated heart failure (ADHF) is a common and highly morbid cardiovascular disorder. Diuresis is a major therapy for the reduction of congestive symptoms. However, most diuretics cause hyponatremia, which is a worsening factor of ADHF patients prognosis. The purpose of this study was to examine the efficacy and safety of tolvaptan, which is a selective vasopressin V2 receptor antagonist and produces water excretion without changes in sodium excretion, compared with carperitide. One hundred and nine hospitalized ADHF patients were enrolled and randomly assigned to tolvaptan or carperitide treatment groups. Subjective symptoms and plasma BNP level were similarly improved by treatment in both groups. Urine volume was significantly higher in the tolvaptan group (P < .05), but volume of water intake was also higher in the tolvaptan group (P < .05). Blood pressure was significantly lower in the carperitide group than in the tolvaptan group after treatment (P < .05). Less adverse events such as worsening heart failure and hypotension requiring drug discontinuation were observed in the tolvaptan group (P = .027). The average drug cost of tolvaptan was lower than that of carperitide (P < .001). Tolvaptan might be a novel promising agent for ADHF in terms of efficacy and safety compared to carperitide.
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影响因子：
9.7
作者：
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通讯作者：
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