title: Potential roles of vaptans in heart failure: experience from clinical trials and considerations for optimizing therapy in target patients.
abstract: Hyponatremia is a known complication in patients with heart failure (HF). HF patients with severe congestion, hyponatremia, and renal insufficiency are difficult to manage and may have worse outcomes. A main cause of hyponatremia is inappropriately elevated level of plasma arginine vasopressin (AVP), which causes water retention at the collecting duct. AVP antagonists have thus been developed to increase aquaresis and serum sodium levels in patients with euvolemic and hypervolemic hyponatremia. Although tolvaptan, an AVP-2 receptor antagonist, did not show outcomes benefit in patients with decompensated HF, prospective studies are ongoing to evaluate its optimal role in targeted HF patients.
authors.affiliation: Division of Pharmacotherapy and Experimental Therapeutics, UNC Eshelman School of Pharmacy, University of North Carolina (UNC) at Chapel Hill, CB#7355, 301 Pharmacy Lane, Chapel Hill, NC 27599-7355, USA.
authors.forename: Tess E
authors.initials: TE
authors.lastname: Lin
authors.affiliation: Division of Cardiology, UNC Heart and Vascular, University of North Carolina (UNC) at Chapel Hill, 160 Dental Circle, Chapel Hill, NC 27599-7075, USA.
authors.forename: Kirkwood F
authors.initials: KF
authors.lastname: Adams
authors.affiliation: Division of Pharmacotherapy and Experimental Therapeutics, UNC Eshelman School of Pharmacy, University of North Carolina (UNC) at Chapel Hill, CB#7355, 301 Pharmacy Lane, Chapel Hill, NC 27599-7355, USA. Electronic address: hpatterson@unc.edu.
authors.forename: J Herbert
authors.initials: JH
authors.lastname: Patterson
mesh_terms: D065092:Antidiuretic Hormone Receptor Antagonists / Q000627:therapeutic use*; D001552:Benzazepines / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D006333:Heart Failure / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D007010:Hyponatremia / Q000150:complications / Q000209:etiology; D011446:Prospective Studies; D000077602:Tolvaptan; D014667:Vasopressins / Q000502:physiology
chemical_list: D065092:Antidiuretic Hormone Receptor Antagonists; D001552:Benzazepines; C106389:conivaptan; D014667:Vasopressins; D000077602:Tolvaptan
keywords: Aquaretic; Conivaptan; Diuretic; Dyspnea; EVEREST; Hyponatremia; Tolvaptan; Vasopressin antagonist