Lin Tess E, Adams Kirkwood F, Patterson J Herbert
Division of Pharmacotherapy and Experimental Therapeutics, UNC Eshelman School of Pharmacy, University of North Carolina (UNC) at Chapel Hill, CB#7355, 301 Pharmacy Lane, Chapel Hill, NC 27599-7355, USA.
Division of Cardiology, UNC Heart and Vascular, University of North Carolina (UNC) at Chapel Hill, 160 Dental Circle, Chapel Hill, NC 27599-7075, USA.
Heart Fail Clin. 2014 Oct;10(4):607-20. doi: 10.1016/j.hfc.2014.07.009.
Hyponatremia is a known complication in patients with heart failure (HF). HF patients with severe congestion, hyponatremia, and renal insufficiency are difficult to manage and may have worse outcomes. A main cause of hyponatremia is inappropriately elevated level of plasma arginine vasopressin (AVP), which causes water retention at the collecting duct. AVP antagonists have thus been developed to increase aquaresis and serum sodium levels in patients with euvolemic and hypervolemic hyponatremia. Although tolvaptan, an AVP-2 receptor antagonist, did not show outcomes benefit in patients with decompensated HF, prospective studies are ongoing to evaluate its optimal role in targeted HF patients.
低钠血症是心力衰竭（HF）患者已知的并发症。伴有严重充血、低钠血症和肾功能不全的HF患者治疗困难，且预后可能更差。低钠血症的一个主要原因是血浆精氨酸加压素（AVP）水平异常升高，这会导致集合管潴留水分。因此，已研发出AVP拮抗剂，以增加等容性和高容性低钠血症患者的水清除率和血清钠水平。尽管AVP-2受体拮抗剂托伐普坦在失代偿性HF患者中未显示出对预后有益，但仍有前瞻性研究在进行，以评估其在特定HF患者中的最佳作用。
