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Hyponatremia in heart failure: The role of arginine vasopressin and diuretics
Cardiovascular Drugs and Therapy, 07/01/09

Rosner MH et al. – Vasopressin-receptor antagonists may prove useful for treatment of heart failure (HF), pending further study of the exact role of these agents.

Methods

Overview of the role of arginine vasopressin (AVP) in development of hyponatremia in HF pts, the role of diuretics, and the potential for vasopressin-receptor antagonists in treatment of HF
MEDLINE literature search for articles relating to HF, diuretics, hyponatremia, AVP, and vasopressin-receptor antagonists

Results

HF affects >5 million US pts and is associated with substantial cost, morbidity, and mortality
Hyponatremia: complication associated with HF and its treatment
Poor outcomes associated with hyponatremia in HF pts can limit use of diuretic therapy
AVP is primary stimulus to hyponatremia development in these pts
Drugs that antagonize the vasopressin V2 receptor primarily responsible for kidney water resorption studied in this setting
These drugs associated with improvements in serum sodium concentration, urine output, and body weight; no long-term mortality benefit in HF pts
In pt subset with baseline hyponatremia, these drugs improved quality of life scores

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