Hyponatremia in heart failure: the role of arginine vasopressin and its antagonism

Congestive Heart Failure
Mitchell H Rosner, Claudio Ronco

Abstract

Heart failure (HF) is associated with substantial cost, morbidity, and mortality. One of the common complications associated with HF, as well as with its treatment, is the development of hyponatremia. Hyponatremia is due to the nonosmotic release of arginine vasopressin (AVP) along with neurohormonal activation of the renin-angiotensin-aldosterone and sympathetic nervous systems. Hyponatremia in patients with HF is associated with poor outcomes and can limit the use of diuretic therapy. Given that AVP is the primary stimulus for the development of hyponatremia in these patients, therapies that target AVP action would seem a logical choice in the therapeutic regimen for HF. Drugs that antagonize the action of AVP at the vasopressin V(2) receptor, which is primarily responsible for water resorption in the kidney, are now available and have been studied in patients with HF. These drugs (termed vaptans) have been associated with improvements in serum sodium concentration, urine output, body weight, and mental functioning but have shown no long-term mortality benefit in patients with HF. The role of vaptans in the HF armament will require further studies that center on the proper timing and indications for their use as well as their...Continue Reading

References

Dec 1, 1992·European Heart Journal·M Burnier, H R Brunner
Aug 1, 1991·The New England Journal of Medicine·UNKNOWN SOLVD InvestigatorsJay N Cohn
Dec 1, 1973·The Journal of Clinical Investigation·F L DunnG L Robertson
Apr 1, 1984·The Journal of Clinical Endocrinology and Metabolism·W PruszczynskiJ Acar
Nov 1, 1983·Clinics in Endocrinology and Metabolism·P H Baylis
Nov 1, 1984·The Journal of Clinical Endocrinology and Metabolism·L S LillyN K Hollenberg
Jul 30, 1981·The New England Journal of Medicine·V L SzatalowiczR W Schrier
Mar 1, 1995·Drug Safety : an International Journal of Medical Toxicology and Drug Experience·A BaglinJ Prinseau
Feb 23, 1999·Advances in Experimental Medicine and Biology·R W Schrier, P Y Martin
Mar 12, 1999·Journal of the American Society of Nephrology : JASN·S NielsenD Marples
May 13, 1999·The American Journal of Medicine·B K KrämerG A Riegger
Aug 19, 1999·The New England Journal of Medicine·R W Schrier, W T Abraham
Feb 1, 2000·The American Journal of the Medical Sciences·A Greenberg
Feb 7, 2002·JAMA : the Journal of the American Medical Association·Anju NohriaLynne Warner Stevenson
Jan 10, 2003·Clinical Endocrinology·San-E Ishikawa, Robert W Schrier
Jul 10, 2003·American Heart Journal·Craig R LeeKirkwood F Adams
Apr 29, 2004·JAMA : the Journal of the American Medical Association·Mihai GheorghiadeUNKNOWN Acute and Chronic Therapeutic Impact of a Vasopressin Antagonist in Congestive Heart Failure (ACTIV in CHF) Investigators
Apr 26, 2005·The American Journal of Cardiology·Ron M Oren
Sep 29, 2005·American Journal of Physiology. Renal Physiology·Lisa C Costello-BoerrigterJohn C Burnett
Oct 19, 2005·Congestive Heart Failure·Domenic A Sica
Jan 10, 2006·The American Journal of Cardiology·Leonardo De LucaMihai Gheorghiade
Apr 12, 2006·Archives of Internal Medicine·Alexander GoldbergDoron Aronson
Jun 22, 2006·Cleveland Clinic Journal of Medicine·Domenic A Sica
Nov 16, 2006·The New England Journal of Medicine·Robert W SchrierUNKNOWN SALT Investigators
Mar 27, 2007·JAMA : the Journal of the American Medical Association·Marvin A KonstamUNKNOWN Efficacy of Vasopressin Antagonism in Heart Failure Outcome Study With Tolvaptan (EVEREST) Investigators
Mar 27, 2007·JAMA : the Journal of the American Medical Association·Mihai GheorghiadeUNKNOWN Efficacy of Vasopressin Antagonism in Heart Failure Outcome Study With Tolvaptan (EVEREST) Investigators
Aug 1, 2007·American Journal of Nephrology·David ZeltserUNKNOWN Conivaptan Study Group
Oct 10, 2007·Archives of Internal Medicine·Mihai GheorghiadeChristopher M O'Connor
Dec 19, 2007·Circulation·Wayne RosamondUNKNOWN American Heart Association Statistics Committee and Stroke Statistics Subcommittee
Jan 18, 2008·Kidney International·R Sharif-NaeiniC W Bourque

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Citations

Aug 28, 2012·The American Journal of Medicine·Tobias BreidthardtChristian Mueller
Jul 12, 2016·International Heart Journal·Daisuke Nitta
Aug 24, 2018·Anesthesia and Analgesia·Alexander ZarbockJohn A Kellum
Jun 28, 2012·International Anesthesiology Clinics·Kyung W Park

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