title: Echocardiographic characteristics of patients with acute heart failure requiring tolvaptan: a retrospective study.
abstract: BACKGROUND
  No study has investigated the admission echocardiographic characteristics of acute heart failure (AHF) patients who are resistant to conventional diuretics and require tolvaptan.
  
  
  METHODS
  We retrospectively analyzed the echocardiographic characteristics of AHF patients who were resistant to conventional diuretics and took tolvaptan (tolvaptan group: 26 patients), and compared them to those who were sensitive to conventional diuretics (conventional group: 180 patients).
  
  
  RESULTS
  The tolvaptan group had a higher left atrial volume index (96.0 ± 85.0 mL/m2 vs. 45.8 ± 25.9 mL/m2, p < 0.0001), maximum inferior vena cava diameter (20.7 ± 6.9 mm vs. 18.1 ± 4.2 mm, p < 0.01), and higher tricuspid regurgitation grade (1.1 ± 0.8 vs. 0.8 ± 0.6, p < 0.05) than the conventional group. However, the left ventricular ejection fraction and end diastolic diameter were similar between the groups. Responders of tolvaptan had no significant echocardiographic differences compared to the non-responders.
  
  
  CONCLUSIONS
  The admission echocardiographic characteristics of AHF patients requiring tolvaptan included a larger left atrium, inferior vena cava, and more severe tricuspid regurgitation. Echocardiography may provide useful information for the early and appropriate initiation of tolvaptan.
authors.affiliation: First Department of Internal Medicine, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan.
authors.forename: Yasuki
authors.initials: Y
authors.lastname: Nakada
authors.affiliation: First Department of Internal Medicine, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan. satosi01@naramed-u.ac.jp.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Okayama
authors.affiliation: First Department of Internal Medicine, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan.
authors.forename: Tomoya
authors.initials: T
authors.lastname: Nakano
authors.affiliation: First Department of Internal Medicine, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan.
authors.forename: Tomoya
authors.initials: T
authors.lastname: Ueda
authors.affiliation: First Department of Internal Medicine, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Onoue
authors.affiliation: First Department of Internal Medicine, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan.
authors.forename: Yukiji
authors.initials: Y
authors.lastname: Takeda
authors.affiliation: First Department of Internal Medicine, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan.
authors.forename: Rika
authors.initials: R
authors.lastname: Kawakami
authors.affiliation: Department of Cardiovascular Internal Medicine, Nara City Hospital, Nara, Japan.
authors.forename: Manabu
authors.initials: M
authors.lastname: Horii
authors.affiliation: First Department of Internal Medicine, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan.
authors.forename: Shiro
authors.initials: S
authors.lastname: Uemura
authors.affiliation: Education Development Center, Nara Medical University, Nara, Japan.
authors.forename: Shinichi
authors.initials: S
authors.lastname: Fujimoto
authors.affiliation: First Department of Internal Medicine, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan.
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Saito
mesh_terms: D000208:Acute Disease; D000368:Aged; D001552:Benzazepines / Q000627:therapeutic use*; D004232:Diuretics / Q000627:therapeutic use; D004452:Echocardiography / Q000187:drug effects / Q000379:methods*; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000000981:diagnostic imaging* / Q000517:prevention & control*; D006801:Humans; D008297:Male; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D000077602:Tolvaptan; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000209:etiology / Q000517:prevention & control*
chemical_list: D001552:Benzazepines; D004232:Diuretics; D000077602:Tolvaptan