title: Hyponatraemia and congestive heart failure refractory to diuretic treatment. Utility of tolvaptan.
abstract: Heart failure (HF) is currently one of the most significant healthcare problems in Spain and has a continuously increasing prevalence. Advances in our understanding of the various biological responses that promote cardiac remodelling and pulmonary venous congestion constitute the basis of current treatment. This article, prepared by members of the HF groups of the Spanish Society of Cardiology and the Spanish Society of Internal Medicine, discusses the current therapeutic strategies for patients with congestion refractory to diuretic treatment. The article includes our clinical experience with the use of tolvaptan as an additional treatment for congestion associated with hyponatraemia. To this end, we propose an algorithm for the use of tolvaptan in patients with congestive HF, natraemia <130mEq/l and poor response to conventional diuretic treatment.
authors.affiliation: Servicio de Medicina Interna, Complexo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, La Coruña, España. Electronic address: antonioposereino@gmail.com.
authors.forename: A
authors.initials: A
authors.lastname: Pose
authors.affiliation: Servicio de Cardiología, Hospital Universitario y Politécnico La Fe, Valencia, España.
authors.forename: L
authors.initials: L
authors.lastname: Almenar
authors.affiliation: Servicio de Medicina Interna, Hospital Universitario Ramón y Cajal, Universidad de Alcalá de Henares, Madrid, España.
authors.forename: L
authors.initials: L
authors.lastname: Manzano
authors.affiliation: Servicio de Cardiología, Clínica Universitaria de Navarra, Pamplona, España.
authors.forename: J J
authors.initials: JJ
authors.lastname: Gavira
authors.affiliation: Servicio de Cardiología, Hospital Universitario Reina Sofía, Córdoba, España.
authors.forename: A
authors.initials: A
authors.lastname: López Granados
authors.affiliation: Servicio de Cardiología, Hospital Universitario 12 de Octubre, Madrid, España.
authors.forename: J
authors.initials: J
authors.lastname: Delgado
authors.affiliation: Servicio de Medicina Interna, Hospital Universitario Virgen de la Macarena, Sevilla, España.
authors.forename: O
authors.initials: O
authors.lastname: Aramburu
authors.affiliation: Servicio de Medicina Interna, Hospital Comarcal de Zafra, Zafra, Badajoz, España.
authors.forename: J C
authors.initials: JC
authors.lastname: Arévalo
authors.affiliation: Servicio de Medicina Interna, Hospital Universitario San Carlos, Madrid, España.
authors.forename: M
authors.initials: M
authors.lastname: Méndez
authors.affiliation: Servicio de Cardiología, Hospital del Mar, Barcelona, España.
authors.forename: J
authors.initials: J
authors.lastname: Comín
authors.affiliation: Servicio de Cardiología, Hospital de Bellvitge, L'Hospitalet de Llobregat, Barcelona, España.
authors.forename: N
authors.initials: N
authors.lastname: Manito
keywords: Congestion; Congestión; Diuretic; Diurético; Heart failure; Insuficiencia cardiaca; Recomendaciones; Recommendations; Refractario; Refractory; Tolvaptan; Tolvaptán