title: Correction of hyponatremia by tolvaptan before left ventricular assist device implantation.
abstract: Hypervolemic hyponatremia is often complicated with advanced heart failure together with increased excretion of sodium by diuretics. Tolvaptan, an oral vasopressin-2-receptor antagonist, has been previously reported to improve congestion and correct hyponatremia through increased excretion of free water. However, there is little evidence concerning the administration of tolvaptan in patients with stage D heart failure. We experienced 2 patients with stage D heart failure who received 3.75 mg/day of tolvaptan to correct hyponatremia before ventricular assist device implantation. It may be useful, even for patients with stage D heart failure, to administer a low dose of tolvaptan to treat hyponatremia before ventricular assist device implantation to avoid a drastic alteration in serum sodium concentration perioperatively.
authors.affiliation: Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: Teruhiko
authors.initials: T
authors.lastname: Imamura
authors.forename: Koichiro
authors.initials: K
authors.lastname: Kinugawa
authors.forename: Taro
authors.initials: T
authors.lastname: Shiga
authors.forename: Naoko
authors.initials: N
authors.lastname: Kato
authors.forename: Miyoko
authors.initials: M
authors.lastname: Endo
authors.forename: Toshiro
authors.initials: T
authors.lastname: Inaba
authors.forename: Hisataka
authors.initials: H
authors.lastname: Maki
authors.forename: Masaru
authors.initials: M
authors.lastname: Hatano
authors.forename: Atsushi
authors.initials: A
authors.lastname: Yao
authors.forename: Yasunobu
authors.initials: Y
authors.lastname: Hirata
authors.forename: Takashi
authors.initials: T
authors.lastname: Nishimura
authors.forename: Shunei
authors.initials: S
authors.lastname: Kyo
authors.forename: Minoru
authors.initials: M
authors.lastname: Ono
authors.forename: Ryozo
authors.initials: R
authors.lastname: Nagai
mesh_terms: D000328:Adult; D001552:Benzazepines / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006333:Heart Failure / Q000097:blood / Q000150:complications / Q000628:therapy*; D006353:Heart-Assist Devices; D006801:Humans; D007010:Hyponatremia / Q000097:blood / Q000188:drug therapy* / Q000209:etiology; D008297:Male; D012964:Sodium / Q000097:blood*; D000077602:Tolvaptan
chemical_list: D001552:Benzazepines; D000077602:Tolvaptan; D012964:Sodium