title: Acute heart failure volume control multicenter randomized (AVCMA) trial: comparison of tolvaptan and carperitide.
abstract: BACKGROUND
  [corrected] 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.
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  Tolvaptan might be a novel promising agent for ADHF in terms of efficacy and safety compared to carperitide.
authors.affiliation: Department of Cardiology and Hematology, Fukushima Medical University, Fukushima, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Suzuki
authors.forename: Akiomi
authors.initials: A
authors.lastname: Yoshihisa
authors.forename: Takayoshi
authors.initials: T
authors.lastname: Yamaki
authors.forename: Koichi
authors.initials: K
authors.lastname: Sugimoto
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kunii
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Nakazato
authors.forename: Yukihiko
authors.initials: Y
authors.lastname: Abe
authors.forename: Tomiyoshi
authors.initials: T
authors.lastname: Saito
authors.forename: Takayuki
authors.initials: T
authors.lastname: Ohwada
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Suzuki
authors.forename: Shu-ichi
authors.initials: S
authors.lastname: Saitoh
authors.forename: Isao
authors.initials: I
authors.lastname: Kubota
authors.forename: Yasuchika
authors.initials: Y
authors.lastname: Takeishi
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D065092:Antidiuretic Hormone Receptor Antagonists; D009320:Atrial Natriuretic Factor / Q000627:therapeutic use*; D001552:Benzazepines / Q000627:therapeutic use*; D004232:Diuretics / Q000627:therapeutic use; D005260:Female; D006333:Heart Failure / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D000077602:Tolvaptan
chemical_list: D065092:Antidiuretic Hormone Receptor Antagonists; D001552:Benzazepines; D004232:Diuretics; C472955:NPPA protein, human; D000077602:Tolvaptan; D009320:Atrial Natriuretic Factor
keywords: acute decompensated heart failure; carperitide; tolvaptan; volume control