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To observe the effects of Tolvaptan on elderly patients with systolic heart failure.
58 cases of NYHA class II-IV patients over 60 years old with systolic heart failure were randomly and double-blindly divided into control group (n=28) and Tolvaptan group (n=30). The patients in control group were injected with furosemide dose of 40mg/d and patients in Tolvaptan group were treated with Tolvaptan dose of 15mg/d. Five days later, laboratory indexes, including urine volume, serum sodium, potassium, serum creatinine were observed from the two groups respectively. The changes in cardiac function, including early diastolic peak flow velocity/late diastolic peak flow velocity (E/A ratio), left ventricular end-diastolic diameter (LVEDD) and left ventricular ejection fraction (LVEF), and NYHA cardiac functional grading were also detected and assessed.
5 days after treatment, patients in Tolvaptan group were with urinary amount 5000±700 ml/day and sodium ion concentration 140±3.4 mmol/L, whereas patients in Control group were with urinary amount 2500±500 ml/day and sodium ion concentration 127±2.9 mmol/L, the difference was with statistical significance (P < 0.05); In Tolvaptan group, echocardiographic parameters of E/A ratio, LVEDD and LVEF values were 1.38±0.11, 57.1%±2.9% and 48.1±4.5 mm respectively. But in Control group, echocardiography indicators E/A ratio, LVEDD and LVEF values were respectively 1.20±0.09, 49.8%±4.7%, 54.1±4.5 mm, there was significant difference between the two groups (P<0.05); In Tolvaptan group, the percentage of NYHA II, NYHA III and NYHA IV were 80%, 16.7% and 3.3% respectively, while in Control group, NYHA II,NYHA III, and NYHA IV accounted for 42.9%, 14.3% and 14.3%, the difference has statistical significance(P<0.05); At the same time, compared with Control group, tolvaptan caused neither reduced potassium level, nor increased serum creatinine in Tolvaptan group, and there were also no deterioration of renal function and no serious adverse reactions in Tolvaptan group.
Tolvaptan can effectively correct the symptoms of elderly patients with systolic heart failure, thus has better clinical application value for elderly patients with systolic heart failure.
This study was supported by the National Natural Science Foundation of China; No. 81355392.