Clinical efficacy of tolvaptan in the treatment of ultra-elderly patients with heart failure with preserved ejection fraction complicated with mild to moderate hyponatremia
Objective To investigate the clinical efficacy of tolvaptan in the treatment of ultra-elderly patients with heart failure with preserved ejection fraction(HFpEF)complicated with mild to moderate hyponatremia.Methods A total of 194 ultra-old HFpEF pa-tients with mild to moderate hyponatremia admitted to General Hospital of Northern Theater Command from October 2019 to October 2022 were selected as the study objects.The patients were divided into group A and group B with 97 cases in each group by random number table.Both groups received conventional anti-heart failure therapy.Group A was treated with furosemide combined with oral so-dium supplementation.Group B was treated with tolvaptan.The blood pressure,24 hours urine volume,body mass,blood sodium(Na+),blood potassium(K+),serum alanine aminotransferase(ALT),serum aspartate aminotransferase(AST),urea nitrogen(BUN),serum creatinine(Scr),N-terminal B-type brain natriuretic peptide precursor(NT-proBNP)of the two groups were compared before treatment,4 days after treatment and 7 days after treatment.The left ventricular ejection fraction(LVEF)of the two groups were compared before treatment and 7 days after treatment.The total effective rate and the occurrence of adverse reactions were compared between the two groups.Results The Na+and 24 hours urine volume of group B at 4 and 7 days after treatment were higher than those of group A,and the differences were statistically significant(P<0.05).There was no significant difference in body mass,systolic blood pressure,diastolic blood pressure,K+,ALT,AST,BUN and Scr between two groups before treatment,4 days and 7 days after treatment(P>0.05).The NT-proBNP of group B at 4 and 7 days after treatment was lower than that of group A,and the differences were statistically significant(P<0.05).The total effective rate of group B was 82.5%(80/97),higher than that of group A(68.0%,66/97),and the difference was statistically significant(P<0.05).The rate of re-hospitalization for heart failure within6 months in group B was 11.3%(11/97),compared with 23.7%(23/97)in group A,the difference was statistically significant(P<0.05).Conclusion Tolvaptan can correct Na+of HFpEF patients with mild to moderate hyponatremia,improve cardiac function,reduce the rate of heart failure rehospitalization,with significant efficacy and high safety.
TolvaptanHeart failure with preserved ejection fractionHyponatremia
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