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Efficacy of Tolvaptan for the Initial Hospitalized Patients With Acute Decompensated Heart Failure (ADHF)
The 21st Annual Scientific Meeting treatment, NYHA functional class was significantly improved, and heart rate was significantly decreased than before (Table 1). However, LVEF was not improved. Alternative treatment for severe heart failure patients is needed.
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JHFS
S85
mission and divided into 2 groups (febuxostat, n = 61; allopurinol, n = 90). After 12 months of follow-up, the cardiac event-free rate in the febuxostat group was significantly higher than that in the allopurinol group (55.7% vs 41.1%; P < .05). Although the baseline characteristics such as the level of brain natriuretic peptide (BNP) and the left ventricular ejection fraction were similar between the 2 groups prior to the introduction of the antihyperuricemics, the percent changes of serum creatinine and BNP levels improved significantly in the febuxostat group than in the allopurinol group. Conclusion: Our data suggest that febuxostat prevents worsening renal function and shows favorable effects in patients with severe HF.
P26-5 The Effectiveness of Continuous Intravenous Administration of Landiolol for Supraventricular Tachycardia Shunsuke Kiuchi, Shinji Hisatake, Ippei Watabnabe, Takayuki Kabuki, Takashi Oka, Shintaro Dobashi, Takahiro Fujii, Takanori Ikeda; Department of Cardiovascular Medicine, Toho University Graduate School of Medicine, Tokyo, Japan Background: Continuous intravenous administration of landiolol has been performed in supraventricular tachycardia (SVT) patients for heart rate (HR) control. SVT includes atrial fibrillation (af) and atrial flutter (AFL), though effectiveness of landiolol on these different arrhythmias are still unclear. Methods: We enrolled 98 consecutive patients with SVT who received landiolol from January 2012 to December 2016. Successful HR control was defined as >20% reduction in baseline HR or with HR < 110 bpm at 2 hours after starting landiolol. We divided the subjects into group A (af, n = 88) and F (AFL, n = 10). HR control level, conversion of normal sinus rhythm (NSR), merger rate of heart failure (HF), laboratory and echocardiographic findings were compared. These findings were also compared to HF patients. Results: The mean HR at baseline were 136.7 ± 21.4 bpm and 142.2 ± 19.7 bpm in group A and F, respectivilty. HR was successfully controlled in 69.3% and 20.0% in group A and F (P < .001). NSR was achieved in 19 patients of group A, and none in group F. Merger rate of HF were 83% and 60% respectively (P = .042). In laboratory and echocardiographic findings, only BNP in group A was significantly higher than group F (727.1 ± 504.5 pg/mL and 390.8 ± 279.4 pg/mL, P = .021). The results were similar in patients with HF. Conclusion: It is important to give thoughts to the type of arrhythmia when administrating landiolol for SVT. Fig. 1. Kaplan-Meier analysis for all-cause mortality after aniodarone treatment.
P27-1 Table 1. Changes Before and During Aniodarone Treatment
Efficacy of Tolvaptan for the Initial Hospitalized Patients With Acute Decompensated Heart Failure (ADHF) Yoriyasu Suzuki, Suguru Murase, Akira Murata, Yusuke Ochiumi, Satoshi Tsujimoto, Ai Kagase, Tatsuya Ito; Division of Cardiovascular Medicine, Nagoya Heart Center, Aichi, Japan Aim: The purpose of this study is to evaluate the efficacy of TLV for the initially hospitalized patients with ADHF. Methods: From 2011 to 2013, consecutive 124 patients initially hospitalized with a diagnosis of ADHF (clinical scenario 2/5) at Nagoya Heart Center. They were treated with or without TLV (TLV (−); n = 81, TLV (+); n = 43). We retrospectively analyzed the clinical outcome of these patients. Results: The results are shown in the Table 1 and Fig. 1. 39.5% of cases were re-hospitalized. In the rehospitalized cases, the incidence of WRF was significantly higher. Conclusion: the treatment with tolvaptan could shortened the duration of bed-rest and prevent WRF and re-hospitalization. The results of this study suggest tolvaptan initiated for acute treatment of patients initially hospitalized with ADHF had effect outcome in daily clinical practice.
P26-2 Comparative Effects of Febuxostat Vs Allopurinol for Severe Congestive Heart Failure Masanori Konishi1, Yasuhiro Maejima1, Yusuke Ito1, Takanobu Yamamoto1, Kenzo Hirao1, Mitsuaki Isobe1,2; 1Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan; 2Sakakibara Heart Institute, Okayama, Japan Background: Although both of febuxostat and allopurinol are effective medicine for the treatment of patients with hyperuricemia, only a few reports have compared for hyperuricemic patients with heart failure (HF). This study was designed to compare the effect of them in patients with severe HF. Methods and Results: A total of 479 consecutive patients with categorized as New York Heart Association class 3 or 4 were retrospectively investigated. Of these patients, 202 were hyperuricemic at admission [8.0 mg/dL < uric acid (UA)] and 151 were administered antihyperuricemics after ad-
P27-2 Factors Associated With Worsening Renal Function in Patients With Acute Decompensated Heart Failure Treated With Tolvaptan Hidetada Fukuoka, Tetsuya Watanabe, Yukinori Shinoda, Kuniyasu Ikeoka, Tomoko Minamisaka, Hirooki Inui, Keisuke Ueno, Soki Inoue, Kentaro Mine, Shiro Hoshida; Department of Cardiovascular Medicine, Yao Municipal Hospital, Osaka, Japan Background: Tolvaptan, a selective V2 receptor antagonist, can increase net volume loss in acute decompensated heart failure (ADHF) with compromised renal function.
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JHFS
S85
mission and divided into 2 groups (febuxostat, n = 61; allopurinol, n = 90). After 12 months of follow-up, the cardiac event-free rate in the febuxostat group was significantly higher than that in the allopurinol group (55.7% vs 41.1%; P < .05). Although the baseline characteristics such as the level of brain natriuretic peptide (BNP) and the left ventricular ejection fraction were similar between the 2 groups prior to the introduction of the antihyperuricemics, the percent changes of serum creatinine and BNP levels improved significantly in the febuxostat group than in the allopurinol group. Conclusion: Our data suggest that febuxostat prevents worsening renal function and shows favorable effects in patients with severe HF.
P26-5 The Effectiveness of Continuous Intravenous Administration of Landiolol for Supraventricular Tachycardia Shunsuke Kiuchi, Shinji Hisatake, Ippei Watabnabe, Takayuki Kabuki, Takashi Oka, Shintaro Dobashi, Takahiro Fujii, Takanori Ikeda; Department of Cardiovascular Medicine, Toho University Graduate School of Medicine, Tokyo, Japan Background: Continuous intravenous administration of landiolol has been performed in supraventricular tachycardia (SVT) patients for heart rate (HR) control. SVT includes atrial fibrillation (af) and atrial flutter (AFL), though effectiveness of landiolol on these different arrhythmias are still unclear. Methods: We enrolled 98 consecutive patients with SVT who received landiolol from January 2012 to December 2016. Successful HR control was defined as >20% reduction in baseline HR or with HR < 110 bpm at 2 hours after starting landiolol. We divided the subjects into group A (af, n = 88) and F (AFL, n = 10). HR control level, conversion of normal sinus rhythm (NSR), merger rate of heart failure (HF), laboratory and echocardiographic findings were compared. These findings were also compared to HF patients. Results: The mean HR at baseline were 136.7 ± 21.4 bpm and 142.2 ± 19.7 bpm in group A and F, respectivilty. HR was successfully controlled in 69.3% and 20.0% in group A and F (P < .001). NSR was achieved in 19 patients of group A, and none in group F. Merger rate of HF were 83% and 60% respectively (P = .042). In laboratory and echocardiographic findings, only BNP in group A was significantly higher than group F (727.1 ± 504.5 pg/mL and 390.8 ± 279.4 pg/mL, P = .021). The results were similar in patients with HF. Conclusion: It is important to give thoughts to the type of arrhythmia when administrating landiolol for SVT. Fig. 1. Kaplan-Meier analysis for all-cause mortality after aniodarone treatment.
P27-1 Table 1. Changes Before and During Aniodarone Treatment
Efficacy of Tolvaptan for the Initial Hospitalized Patients With Acute Decompensated Heart Failure (ADHF) Yoriyasu Suzuki, Suguru Murase, Akira Murata, Yusuke Ochiumi, Satoshi Tsujimoto, Ai Kagase, Tatsuya Ito; Division of Cardiovascular Medicine, Nagoya Heart Center, Aichi, Japan Aim: The purpose of this study is to evaluate the efficacy of TLV for the initially hospitalized patients with ADHF. Methods: From 2011 to 2013, consecutive 124 patients initially hospitalized with a diagnosis of ADHF (clinical scenario 2/5) at Nagoya Heart Center. They were treated with or without TLV (TLV (−); n = 81, TLV (+); n = 43). We retrospectively analyzed the clinical outcome of these patients. Results: The results are shown in the Table 1 and Fig. 1. 39.5% of cases were re-hospitalized. In the rehospitalized cases, the incidence of WRF was significantly higher. Conclusion: the treatment with tolvaptan could shortened the duration of bed-rest and prevent WRF and re-hospitalization. The results of this study suggest tolvaptan initiated for acute treatment of patients initially hospitalized with ADHF had effect outcome in daily clinical practice.
P26-2 Comparative Effects of Febuxostat Vs Allopurinol for Severe Congestive Heart Failure Masanori Konishi1, Yasuhiro Maejima1, Yusuke Ito1, Takanobu Yamamoto1, Kenzo Hirao1, Mitsuaki Isobe1,2; 1Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan; 2Sakakibara Heart Institute, Okayama, Japan Background: Although both of febuxostat and allopurinol are effective medicine for the treatment of patients with hyperuricemia, only a few reports have compared for hyperuricemic patients with heart failure (HF). This study was designed to compare the effect of them in patients with severe HF. Methods and Results: A total of 479 consecutive patients with categorized as New York Heart Association class 3 or 4 were retrospectively investigated. Of these patients, 202 were hyperuricemic at admission [8.0 mg/dL < uric acid (UA)] and 151 were administered antihyperuricemics after ad-
P27-2 Factors Associated With Worsening Renal Function in Patients With Acute Decompensated Heart Failure Treated With Tolvaptan Hidetada Fukuoka, Tetsuya Watanabe, Yukinori Shinoda, Kuniyasu Ikeoka, Tomoko Minamisaka, Hirooki Inui, Keisuke Ueno, Soki Inoue, Kentaro Mine, Shiro Hoshida; Department of Cardiovascular Medicine, Yao Municipal Hospital, Osaka, Japan Background: Tolvaptan, a selective V2 receptor antagonist, can increase net volume loss in acute decompensated heart failure (ADHF) with compromised renal function.