title: Predictability of tricuspid annular plane systolic excursion for the effectiveness of tolvaptan in patients with heart failure.
abstract: There is no echocardiographic predictor of the effectiveness of tolvaptan in patients with heart failure (HF). The aim of this study was to investigate the echocardiographic predictor of responders to tolvaptan in patients with HF.
  
  
  
  This observational study consisted of 62 consecutive in-hospital patients with HF who received tolvaptan with volume overload despite standard therapies. The echocardiography data were obtained within 1 week before the administration of tolvaptan. Tolvaptan responders were defined as those having a body weight decrease from baseline >1 kg on the morning of day 8.
  
  
  
  The mean age of the 62 patients was 75.1 ± 13.9 years, and 45 patients (72.6%) were considered to be responders. Tricuspid annular plane systolic excursion (TAPSE) was significantly higher (17.1 ± 3.8 vs. 13.0 ± 3.9 mm; p = 0.0004) and the tricuspid valve regurgitation pressure gradient (33.3 ± 14.6 vs. 44.9 ± 12.2 mmHg; p = 0.007) and estimated right atrium pressure (7.8 ± 4.2 vs. 10.3 ± 4.5 mmHg; p = 0.043) were significantly lower in the Responder group than in the Non-responder group. In a multivariate logistic regression analysis, TAPSE was found to be an independent predictor of response (odds ratio 1.28; 95% confidence interval 1.03-1.60). According to the receiver operating characteristics analysis, the area under the curve of TAPSE was the largest among the parameters measured by echocardiography. The cut-off value for TAPSE to predict responders was determined to be 17.0 mm (sensitivity = 56.8%, specificity = 94.1%).
  
  
  
  TAPSE is a simple predictor of the effectiveness of tolvaptan in patients with HF.
authors.affiliation: Department of Cardiology, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Niwa
authors.affiliation: Department of Cardiology, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Japan.
authors.forename: Katsuhisa
authors.initials: K
authors.lastname: Waseda
authors.affiliation: Department of Cardiology, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Japan. tomofumi@aichi-med-u.ac.jp.
authors.forename: Tomofumi
authors.initials: T
authors.lastname: Mizuno
authors.affiliation: Department of Cardiology, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Nakano
authors.affiliation: Department of Cardiology, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Japan.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Mukai
authors.affiliation: Department of Cardiology, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Japan.
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Wakabayashi
authors.affiliation: Department of Cardiology, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Watanabe
authors.affiliation: Department of Cardiology, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Japan.
authors.forename: Hirohiko
authors.initials: H
authors.lastname: Ando
authors.affiliation: Department of Cardiology, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Takashima
authors.affiliation: Department of Cardiology, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Japan.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Amano
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D065092:Antidiuretic Hormone Receptor Antagonists / Q000627:therapeutic use*; D001552:Benzazepines / Q000627:therapeutic use*; D004452:Echocardiography; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012372:ROC Curve; D013599:Systole; D000077602:Tolvaptan; D014261:Tricuspid Valve / Q000000981:diagnostic imaging*; D014262:Tricuspid Valve Insufficiency / Q000150:complications / Q000000981:diagnostic imaging*; D014883:Water-Electrolyte Imbalance / Q000150:complications / Q000188:drug therapy*
chemical_list: D065092:Antidiuretic Hormone Receptor Antagonists; D001552:Benzazepines; D000077602:Tolvaptan
keywords: Echocardiography; Effectiveness of tolvaptan; Right ventricle dysfunction; TAPSE