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Combination of Urinary Sodium/Creatinine Ratio and Plasma Brain Natriuretic Peptide Level Predicts Successful Tolvaptan Therapy in Patients with Heart Failure and Volume Overload
http://hdl.handle.net/10076/00016981
http://hdl.handle.net/10076/00016981b5c029fb-60b3-452f-ab35-36106f236c6c
| 名前 / ファイル | ライセンス | アクション |
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2015DM039 (836.2 kB)
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| Item type | 学位論文 / Thesis or Dissertation(1) | |||||||||||
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| 公開日 | 2017-07-04 | |||||||||||
| タイトル | ||||||||||||
| タイトル | Combination of Urinary Sodium/Creatinine Ratio and Plasma Brain Natriuretic Peptide Level Predicts Successful Tolvaptan Therapy in Patients with Heart Failure and Volume Overload | |||||||||||
| 言語 | en | |||||||||||
| 言語 | ||||||||||||
| 言語 | eng | |||||||||||
| キーワード | ||||||||||||
| 主題Scheme | Other | |||||||||||
| 主題 | vasopressin V2-receptor antagonist | |||||||||||
| キーワード | ||||||||||||
| 主題Scheme | Other | |||||||||||
| 主題 | loop diuretics | |||||||||||
| キーワード | ||||||||||||
| 主題Scheme | Other | |||||||||||
| 主題 | diuresis | |||||||||||
| キーワード | ||||||||||||
| 主題Scheme | Other | |||||||||||
| 主題 | heart failure | |||||||||||
| 資源タイプ | ||||||||||||
| 資源タイプ識別子 | http://purl.org/coar/resource_type/c_db06 | |||||||||||
| 資源タイプ | doctoral thesis | |||||||||||
| アクセス権 | ||||||||||||
| アクセス権 | open access | |||||||||||
| アクセス権URI | http://purl.org/coar/access_right/c_abf2 | |||||||||||
| 著者 |
佐藤, 雄一
× 佐藤, 雄一
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| 抄録 | ||||||||||||
| 内容記述タイプ | Abstract | |||||||||||
| 内容記述 | To evaluate short-term clinical and hemodynamic effects of tolvaptan therapy and to identify predictors of the therapeutic outcomes, we retrospectively recruited sixty consecutive hospitalized heart failure (HF) patients (70 ± 11 years) with volume overload. The subjects were divided into two groups on the basis of the changes in HF symptom scores and hemodynamic status assessed by right heart catheterization after tolvaptan therapy (median: 7 days). The majority of patients were successfully treated (Group 1). However, 22% of patients (Group 2) were unsuccessfully treated, in whom 1) HF symptom score worsened or 2) there was a stationary HF symptom score ≥6 points, and mean PCWP >18 mmHg and mean RAP >10 mmHg, after tolvaptan therapy. HF symptom scores, hemodynamic parameters and plasma brain natriuretic peptide (BNP) level improved in Group 1, but all of these parameters remained unchanged in Group 2. Lower urine sodium/creatinine ratio (UNa/UCr) and higher BNP level at baseline were independently associated with unsuccessful tolvaptan therapy, and UNa/UCr best predicts unsuccessful tolvaptan therapy with a cut-off value of 46.5 mEq/g-Cr (AUC 0.858, 95% CI: 0.743-0.974, sensitivity 81%, specificity 77%, p <0.01). Double-positive results of UNa/UCr <46.5 mEq/g-Cr and plasma BNP level >778 pg/ml predicted unsuccessful tolvaptan therapy with high diagnostic accuracy (sensitivity 54%, specificity 100%, positive predictive value 100%, negative predictive value 89% and accuracy 90%). In summary, short-term tolvaptan therapy ameliorated HF symptoms and provided hemodynamic improvement in the majority of patients, and UNa/UCr and BNP level strongly predicted the therapeutic outcomes. | |||||||||||
| 内容記述 | ||||||||||||
| 内容記述タイプ | Other | |||||||||||
| 内容記述 | 本文 / Department of Cardiology and Nephrology, Mie University Graduate School of Medicine | |||||||||||
| 内容記述 | ||||||||||||
| 内容記述タイプ | Other | |||||||||||
| 内容記述 | 36p | |||||||||||
| 書誌情報 |
発行日 2016-03-25 |
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| DOI | ||||||||||||
| 識別子タイプ | DOI | |||||||||||
| 関連識別子 | 10.1536/ihj.15-330 | |||||||||||
| 権利 | ||||||||||||
| 権利情報 | (C) 2016 by the International Heart Journal Association | |||||||||||
| フォーマット | ||||||||||||
| 内容記述タイプ | Other | |||||||||||
| 内容記述 | application/pdf | |||||||||||
| 著者版フラグ | ||||||||||||
| 出版タイプ | VoR | |||||||||||
| 出版タイプResource | http://purl.org/coar/version/c_970fb48d4fbd8a85 | |||||||||||
| 出版者 | ||||||||||||
| 出版者 | 三重大学 | |||||||||||
| 出版者（ヨミ） | ||||||||||||
| 値 | ミエダイガク | |||||||||||
| 関係URI | ||||||||||||
| 関連名称 | http://doi.org/10.1536/ihj.15-330 | |||||||||||
| 学位名 | ||||||||||||
| 学位名 | 博士(医学) | |||||||||||
| 学位授与機関 | ||||||||||||
| 学位授与機関識別子Scheme | kakenhi | |||||||||||
| 学位授与機関識別子 | 14101 | |||||||||||
| 学位授与機関名 | 三重大学 | |||||||||||
| 学位授与年月日 | ||||||||||||
| 学位授与年月日 | 2016-03-25 | |||||||||||
| 学位授与番号 | ||||||||||||
| 学位授与番号 | 甲医学第1776号 | |||||||||||
| ノート | ||||||||||||
| 値 | International Heart Journal, 57(2), 2016, pp. 211-219 ISBN : 1349-2365 に掲載 | |||||||||||
| 資源タイプ（三重大） | ||||||||||||
| 値 | Doctoral Dissertation / 博士論文 | |||||||||||
