Impact of Tolvaptan Combined with Low-Dose Dopamine in Heart Failure Patients with Acute Kidney Injury

IF 1.2 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

International heart journal Pub Date : 2024-05-31 DOI:10.1536/ihj.23-442

Lingchao Yang, Jian Wang, Ying Yu, Yanyan Li, Song Zhang

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Abstract

The impact of tolvaptan and low-dose dopamine on heart failure (HF) patients with acute kidney injury (AKI) remains uncertain from a clinical standpoint.

HF patients with AKI were selected and divided in a 1:1 fashion into the dopamine combined with the tolvaptan group (DTG), the tolvaptan group (TG), and the control group (CG). According to the standard of care, TG received tolvaptan 15 mg orally daily for a week. DTG received combination treatment, including 7 consecutive days of dopamine infusion (2 μg/kg・minutes) and oral tolvaptan 15 mg. Venous blood and urine samples were taken before and after therapy. The primary endpoint was the cardiorenal serological index after 7 days of treatment.

Sixty-five patients were chosen randomly for the DTG (22 patients), TG (20 patients), and CG (23 patients), which were similar before the treatment. The serum indexes related to cardiac function (N-terminal probrain natriuretic peptide and cardiac troponin I) in DTG were decreased, compared with TG and CG (P < 0.05). Furthermore, the serological markers of renal function (serum cystatin C, serum creatinine, and neutrophil gelatinase-associated lipocalin) in DTG were lower than those in TG and CG (P < 0.05). There was no significant difference in the incidence of adverse reactions among groups.

Low-dose dopamine combined with tolvaptan can markedly improve patients' cardiac and renal function. This may be considered a new therapeutic method for HF patients with AKI.

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托伐普坦联合小剂量多巴胺对急性肾损伤心衰患者的影响

从临床角度来看，托伐普坦和小剂量多巴胺对急性肾损伤（AKI）的心力衰竭（HF）患者的影响仍不确定。我们挑选了患有AKI的HF患者，并按1:1的比例将其分为多巴胺联合托伐普坦组（DTG）、托伐普坦组（TG）和对照组（CG）。根据标准治疗方案，TG 组每天口服 15 毫克托伐普坦，为期一周。DTG组接受联合治疗，包括连续7天输注多巴胺（2微克/千克・分钟）和口服托伐普坦15毫克。治疗前后均采集静脉血和尿液样本。65 名患者被随机选入 DTG（22 人）、TG（20 人）和 CG（23 人）组，治疗前的血清学指标相似。与 TG 和 CG 相比，DTG 患者血清中与心脏功能相关的指标（N-末端 probrain 利钠肽和心肌肌钙蛋白 I）均有所下降（P < 0.05）。此外，DTG 的肾功能血清学指标（血清胱抑素 C、血清肌酐和中性粒细胞明胶酶相关脂褐质）也低于 TG 和 CG（P < 0.05）。小剂量多巴胺联合托伐普坦能明显改善患者的心功能和肾功能。小剂量多巴胺联合托伐普坦能明显改善患者的心功能和肾功能，可被视为高危肾脏病患者的一种新的治疗方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International heart journal 医学-心血管系统

CiteScore

2.50

自引率

6.70%

发文量

148

审稿时长

6-12 weeks

期刊介绍： Authors of research articles should disclose at the time of submission any financial arrangement they may have with a company whose product figures prominently in the submitted manuscript or with a company making a competing product. Such information will be held in confidence while the paper is under review and will not influence the editorial decision, but if the article is accepted for publication, the editors will usually discuss with the authors the manner in which such information is to be communicated to the reader.