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Relationship between the efficacy of tolvaptan and hemoglobin levels in acute decompensated heart failure

Journal of Cardiology & Current Research
Takahiro Shibata,1 Eiko Fukuro,1 Hirotake Takahashi,1 Yosuke Kayama,1 Chikara Mori,1 Makoto Kawai,2 Michihiro Yoshimura2


Objective: The purpose of this study is to investigate the factors that influence the
effectiveness of tolvaptan treatment for acute decompensated heart failure.
Methods and patients: This retrospective study included 102 patients with acute
decompensated heart failure who were considered to require tolvaptan. We investigated
whether tolvaptan administration was completed within 7 days or more and divided patients
into two groups accordingly (responders, n = 35, non-responders, n = 67). Univariate,
multivariate analysis and structural equation modeling were used to investigate the various
clinical features involved in the success or failure of tolvaptan administration within 7 days.
Among the investigation of various factors, changes in blood urea nitrogen, creatinine, and
hemoglobin before and after tolvaptan administration were associated with the completion
of tolvaptan administration. In order to proceed with further examination, we examined
using a path diagram based on structural equation modeling.
Results: It was found that low hemoglobin before treatment and high hemoglobin after
treatment are related to the success of the completion of tolvaptan. Other factors were
not related to the success of tolvaptan administration. The effectiveness of tolvaptan in
pretreatment patients with low hemoglobin is especially important and hemoglobin level
will be a valuable marker.
Conclusion: This study showed that tolvaptan may be more effective at low hemoglobin in
acute decompensated heart failure, which is generally difficult to treat. In that case, active
use of tolvaptan is recommended.


Decompensated heart failure, hemoglobin, tolvaptan