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Vasopressin Receptor Antagonists (Vaptans) in Heart Failure
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| Zeitschriftentitel: | International Cardiovascular Forum Journal |
|---|---|
| Personen und Körperschaften: | , |
| In: | International Cardiovascular Forum Journal, 17, 2019 |
| Format: | E-Article |
| Sprache: | Unbestimmt |
| veröffentlicht: |
International Cardiovascular Forum Journal
|
| Schlagwörter: |
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Lipiec, Piotr Metra, Marco Lipiec, Piotr Metra, Marco |
|---|---|
| author |
Lipiec, Piotr Metra, Marco |
| spellingShingle |
Lipiec, Piotr Metra, Marco International Cardiovascular Forum Journal Vasopressin Receptor Antagonists (Vaptans) in Heart Failure Pulmonary and Respiratory Medicine Pediatrics, Perinatology and Child Health |
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lipiec, piotr |
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Lipiec, Piotr Metra, Marco 2409-3424 2410-2636 International Cardiovascular Forum Journal Pulmonary and Respiratory Medicine Pediatrics, Perinatology and Child Health http://dx.doi.org/10.17987/icfj.v17i0.605 <jats:p>Arginine vasopressin (a peptide neuroendocrine hormone) levels are elevated in patients with HF. Acting through 3 receptor subtypes, it can cause vasoconstriction and cardiac remodelling (receptors V1a), adrenocorticotropic hormone release (receptors V1b) and water reabsorption (receptors V2), thereby increasing preload and afterload. Vasopressin-receptor antagonists (vaptans), induce hypotonic diuresis and have been proposed as a treatment option for hyponatraemia, a known complication of HF. Three vaptans have been so tested; tolvaptan, conivaptan and lixivaptan, and two (tolvaptan and conivaptan) have been approved for clinical use in hyponatraemia (in the USA). The EVEREST trial studied tolvaptan in over 4100 patients hospitalized with an exacerbation of chronic HF with reduced LVEF. No effect was seen on long-term mortality or HF-related morbidity, but there was greater weight loss and better dyspnoea and oedema relief over the short-term. Similar results were seen in the AQUAMARINE study. The 2016 European HF guidelines, therefore gave the limited recommendation: “Tolvaptan may be used to treat patients with volume overload and resistant hyponatraemia”. Despite targeting an attractive therapeutic target, vasopressin receptor antagonists (vaptans) have to date played only a minor role in our management of HF.</jats:p> Vasopressin Receptor Antagonists (Vaptans) in Heart Failure International Cardiovascular Forum Journal |
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| title |
Vasopressin Receptor Antagonists (Vaptans) in Heart Failure |
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Vasopressin Receptor Antagonists (Vaptans) in Heart Failure |
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Vasopressin Receptor Antagonists (Vaptans) in Heart Failure |
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Vasopressin Receptor Antagonists (Vaptans) in Heart Failure |
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Vasopressin Receptor Antagonists (Vaptans) in Heart Failure |
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Vasopressin Receptor Antagonists (Vaptans) in Heart Failure |
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vasopressin receptor antagonists (vaptans) in heart failure |
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Pulmonary and Respiratory Medicine Pediatrics, Perinatology and Child Health |
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http://dx.doi.org/10.17987/icfj.v17i0.605 |
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<jats:p>Arginine vasopressin (a peptide neuroendocrine hormone) levels are elevated in patients with HF. Acting through 3 receptor subtypes, it can cause vasoconstriction and cardiac remodelling (receptors V1a), adrenocorticotropic hormone release (receptors V1b) and water reabsorption (receptors V2), thereby increasing preload and afterload. Vasopressin-receptor antagonists (vaptans), induce hypotonic diuresis and have been proposed as a treatment option for hyponatraemia, a known complication of HF. Three vaptans have been so tested; tolvaptan, conivaptan and lixivaptan, and two (tolvaptan and conivaptan) have been approved for clinical use in hyponatraemia (in the USA). The EVEREST trial studied tolvaptan in over 4100 patients hospitalized with an exacerbation of chronic HF with reduced LVEF. No effect was seen on long-term mortality or HF-related morbidity, but there was greater weight loss and better dyspnoea and oedema relief over the short-term. Similar results were seen in the AQUAMARINE study. The 2016 European HF guidelines, therefore gave the limited recommendation: “Tolvaptan may be used to treat patients with volume overload and resistant hyponatraemia”. Despite targeting an attractive therapeutic target, vasopressin receptor antagonists (vaptans) have to date played only a minor role in our management of HF.</jats:p> |
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| description | <jats:p>Arginine vasopressin (a peptide neuroendocrine hormone) levels are elevated in patients with HF. Acting through 3 receptor subtypes, it can cause vasoconstriction and cardiac remodelling (receptors V1a), adrenocorticotropic hormone release (receptors V1b) and water reabsorption (receptors V2), thereby increasing preload and afterload. Vasopressin-receptor antagonists (vaptans), induce hypotonic diuresis and have been proposed as a treatment option for hyponatraemia, a known complication of HF. Three vaptans have been so tested; tolvaptan, conivaptan and lixivaptan, and two (tolvaptan and conivaptan) have been approved for clinical use in hyponatraemia (in the USA). The EVEREST trial studied tolvaptan in over 4100 patients hospitalized with an exacerbation of chronic HF with reduced LVEF. No effect was seen on long-term mortality or HF-related morbidity, but there was greater weight loss and better dyspnoea and oedema relief over the short-term. Similar results were seen in the AQUAMARINE study. The 2016 European HF guidelines, therefore gave the limited recommendation: “Tolvaptan may be used to treat patients with volume overload and resistant hyponatraemia”. Despite targeting an attractive therapeutic target, vasopressin receptor antagonists (vaptans) have to date played only a minor role in our management of HF.</jats:p> |
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| spelling | Lipiec, Piotr Metra, Marco 2409-3424 2410-2636 International Cardiovascular Forum Journal Pulmonary and Respiratory Medicine Pediatrics, Perinatology and Child Health http://dx.doi.org/10.17987/icfj.v17i0.605 <jats:p>Arginine vasopressin (a peptide neuroendocrine hormone) levels are elevated in patients with HF. Acting through 3 receptor subtypes, it can cause vasoconstriction and cardiac remodelling (receptors V1a), adrenocorticotropic hormone release (receptors V1b) and water reabsorption (receptors V2), thereby increasing preload and afterload. Vasopressin-receptor antagonists (vaptans), induce hypotonic diuresis and have been proposed as a treatment option for hyponatraemia, a known complication of HF. Three vaptans have been so tested; tolvaptan, conivaptan and lixivaptan, and two (tolvaptan and conivaptan) have been approved for clinical use in hyponatraemia (in the USA). The EVEREST trial studied tolvaptan in over 4100 patients hospitalized with an exacerbation of chronic HF with reduced LVEF. No effect was seen on long-term mortality or HF-related morbidity, but there was greater weight loss and better dyspnoea and oedema relief over the short-term. Similar results were seen in the AQUAMARINE study. The 2016 European HF guidelines, therefore gave the limited recommendation: “Tolvaptan may be used to treat patients with volume overload and resistant hyponatraemia”. Despite targeting an attractive therapeutic target, vasopressin receptor antagonists (vaptans) have to date played only a minor role in our management of HF.</jats:p> Vasopressin Receptor Antagonists (Vaptans) in Heart Failure International Cardiovascular Forum Journal |
| spellingShingle | Lipiec, Piotr, Metra, Marco, International Cardiovascular Forum Journal, Vasopressin Receptor Antagonists (Vaptans) in Heart Failure, Pulmonary and Respiratory Medicine, Pediatrics, Perinatology and Child Health |
| title | Vasopressin Receptor Antagonists (Vaptans) in Heart Failure |
| title_full | Vasopressin Receptor Antagonists (Vaptans) in Heart Failure |
| title_fullStr | Vasopressin Receptor Antagonists (Vaptans) in Heart Failure |
| title_full_unstemmed | Vasopressin Receptor Antagonists (Vaptans) in Heart Failure |
| title_short | Vasopressin Receptor Antagonists (Vaptans) in Heart Failure |
| title_sort | vasopressin receptor antagonists (vaptans) in heart failure |
| title_unstemmed | Vasopressin Receptor Antagonists (Vaptans) in Heart Failure |
| topic | Pulmonary and Respiratory Medicine, Pediatrics, Perinatology and Child Health |
| url | http://dx.doi.org/10.17987/icfj.v17i0.605 |