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This study was conducted in order to evaluate the renal protective effect of adding tolvaptan (TLV), compared to increasing the furosemide (FRM) dose, for the treatment of acute decompensated heart failure (ADHF) in a real-world elderly patient population. Methods: This randomized controlled trial enrolled 52 consecutive hospitalized patients (age 83.4 +/- 9.6 years) with ADHF. The patients were assigned alternately to either the TLV group (TLV plus conventional treatment, n = 26) or the FRM group (increasing the dose of FRM, n = 26). TLV was administered within 24 h from admission. Results: The incidence of worsening renal function (WRF) within 7 days from admission was significantly lower in the TLV group (26.9% vs. 57.7%, p = 0.025). Furthermore, the rates of occurrence of persistent and late-onset (\u003e= 5 days from admission) WRF were significantly lower in the TLV group. Persistent and late-onset WRF were significantly associated with a higher incidence of cardiac death or readmission for worsening heart failure in the 90 days following discharge, compared to transient and early-onset WRF, respectively. Conclusions: Early administration of TLV, compared to increased FRM dosage, reduces the incidence of WRF in real-world elderly ADHF patients. In addition, it reduces the occurrence of \u0027worse\u0027 WRF-persistent and late-onset WRF-which are associated with increased rates of cardiac death or readmission for worsening heart failure in the 90 days after discharge. (C) 2015 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved."}]}, "item_1627890986942": {"attribute_name": "\u51fa\u7248\u30bf\u30a4\u30d7", "attribute_value_mlt": [{"subitem_version_resource": "http://purl.org/coar/version/c_be7fb7dd8ff6fe43", "subitem_version_type": "NA"}]}, "item_creator": {"attribute_name": "\u8457\u8005", "attribute_type": "creator", "attribute_value_mlt": [{"creatorNames": [{"creatorName": "\u6728\u6751, \u548c\u5e83"}], "nameIdentifiers": [{"nameIdentifier": "105894", "nameIdentifierScheme": "WEKO"}]}]}, "item_files": {"attribute_name": "\u30d5\u30a1\u30a4\u30eb\u60c5\u5831", "attribute_type": "file", "attribute_value_mlt": [{"accessrole": "open_date", "date": [{"dateType": "Available", "dateValue": "2018-06-28"}], "displaytype": "detail", "download_preview_message": "", "file_order": 0, "filename": "13MH015A_yoshi.pdf", "filesize": [{"value": "125.9 kB"}], "format": "application/pdf", "future_date_message": "", "is_thumbnail": false, "licensetype": "license_note", "mimetype": "application/pdf", "size": 125900.0, "url": {"label": "\u5185\u5bb9\u306e\u8981\u65e8", "url": "https://soar-ir.repo.nii.ac.jp/record/19941/files/13MH015A_yoshi.pdf"}, "version_id": "6482f668-58af-47b2-88a1-67604299e641"}, {"accessrole": "open_date", "date": [{"dateType": "Available", "dateValue": "2018-06-28"}], "displaytype": "detail", "download_preview_message": "", "file_order": 1, "filename": "13MH015A_shinsa.pdf", "filesize": [{"value": "119.5 kB"}], "format": "application/pdf", "future_date_message": "", "is_thumbnail": false, "licensetype": "license_note", "mimetype": "application/pdf", "size": 119500.0, "url": {"label": "\u5be9\u67fb\u7d50\u679c\u306e\u8981\u65e8", "url": "https://soar-ir.repo.nii.ac.jp/record/19941/files/13MH015A_shinsa.pdf"}, "version_id": "c275979a-9c53-4db8-9081-91a350651aa6"}, {"accessrole": "open_date", "date": [{"dateType": "Available", "dateValue": "2018-06-28"}], "displaytype": "detail", "download_preview_message": "", "file_order": 2, "filename": "13MH015A_ronbun.pdf", "filesize": [{"value": "1.1 MB"}], "format": "application/pdf", "future_date_message": "", "is_thumbnail": false, "licensefree": "\u00a9 2015 Japanese College of Cardiology. 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Early administration of tolvaptan preserves renal function in elderly patients with acute decompensated heart failure(高齢急性非代償性心不全患者へのトルバプタン早期投与は腎機能を保護する)
http://hdl.handle.net/10091/00020702
90ec2474-ee86-4570-addc-28187e864254
名前 / ファイル | ライセンス | アクション | |
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Item type | 学位論文 / Thesis or Dissertation(1) | |||||
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公開日 | 2018-06-28 | |||||
タイトル | ||||||
言語 | en | |||||
タイトル | Early administration of tolvaptan preserves renal function in elderly patients with acute decompensated heart failure(高齢急性非代償性心不全患者へのトルバプタン早期投与は腎機能を保護する) | |||||
言語 | ||||||
言語 | eng | |||||
資源タイプ | ||||||
資源 | http://purl.org/coar/resource_type/c_db06 | |||||
タイプ | doctoral thesis | |||||
著者 |
木村, 和広
× 木村, 和広 |
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出版者 | ||||||
出版者 | 信州大学 | |||||
引用 | ||||||
内容記述タイプ | Other | |||||
内容記述 | 木村 和広. Early administration of tolvaptan preserves renal function in elderly patients with acute decompensated heart failure(高齢急性非代償性心不全患者へのトルバプタン早期投与は腎機能を保護する). 信州大学, 2017, 博士論文. | |||||
書誌情報 |
発行日 2017-03-31 |
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学位授与番号 | ||||||
学位授与番号 | 13601甲第1096号 | |||||
学位授与年月日 | ||||||
学位授与年月日 | 2017-03-31 | |||||
学位名 | ||||||
学位名 | 博士(医学) | |||||
学位授与機関 | ||||||
学位授与機関名 | ||||||
学位授与機関名 | 信州大学(Shinshu university) | |||||
学位の区分 | ||||||
Doctoral | ||||||
学位の分野 | ||||||
医学 | ||||||
学位の報告番号 | ||||||
甲第1096号 | ||||||
内容記述 | ||||||
内容記述タイプ | Other | |||||
内容記述 | 雑誌に発表。JOURNAL OF CARDIOLOGY. 67(5-6):399-405 (2016); doi:10.1016/j.jjcc.2015.09.020. | |||||
資源タイプ(コンテンツの種類) | ||||||
内容記述タイプ | Other | |||||
内容記述 | Thesis | |||||
PubMed | ||||||
関連識別子 | ||||||
識別子タイプ | PMID | |||||
関連識別子 | http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?CMD=search&DB=pubmed&term=26692119 | |||||
関連名称 | ||||||
関連名称 | 26692119 | |||||
DOI | ||||||
関連識別子 | ||||||
識別子タイプ | DOI | |||||
関連識別子 | https://doi.org/10.1016/j.jjcc.2015.09.020 | |||||
関連名称 | ||||||
関連名称 | 10.1016/j.jjcc.2015.09.020 | |||||
権利 | ||||||
権利情報 | © 2015 Japanese College of Cardiology. Published by Elsevier Ireland Ltd. All rights reserved. | |||||
出版タイプ | ||||||
出版タイプ | NA | |||||
出版タイプResource | http://purl.org/coar/version/c_be7fb7dd8ff6fe43 | |||||
WoS | ||||||
Web of Science | ||||||
URL | http://gateway.isiknowledge.com/gateway/Gateway.cgi?&GWVersion=2&SrcAuth=ShinshuUniv&SrcApp=ShinshuUniv&DestLinkType=FullRecord&DestApp=WOS&KeyUT=000377819600002 |