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首页> 外文期刊>Journal of cardiac failure >Efficacy and safety of the vasopressin V1A/V2-receptor antagonist conivaptan in acute decompensated heart failure: a dose-ranging pilot study.
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Efficacy and safety of the vasopressin V1A/V2-receptor antagonist conivaptan in acute decompensated heart failure: a dose-ranging pilot study.

机译:血管加压素V1A / V2-受体拮抗剂康尼普坦在急性失代偿性心力衰竭中的疗效和安全性:一项剂量范围的试验研究。

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摘要

BACKGROUND: Hospitalization for acute decompensated heart failure (ADHF) involves substantial morbidity and mortality. Current management strategies have major limitations, and there has been little progress in the development of newer therapies. Arginine vasopressin-receptor antagonists may have promise in the treatment of ADHF in view of their ability to facilitate diuresis. This pilot study was designed to evaluate the efficacy and safety of intravenous conivaptan, a dual arginine vasopressin V(1A)/V(2)-receptor antagonist, in treating ADHF. METHODS AND RESULTS: In a double-blind, multicenter trial, 170 patients hospitalized for worsening heart failure and given standard therapy were randomly assigned to treatment with conivaptan (20-mg loading dose followed by 2 successive 24-hour continuous infusions of 40, 80, or 120 mg/d) or placebo. The conivaptan and placebo groups did not differ significantly in patient or clinician assessments of global and respiratory status at 48 hours. There was no evidence of worsening heart failure in any group. Conivaptan at each dosage increased urine output significantly more than placebo at 24 hours (P
机译:背景:急性失代偿性心力衰竭(ADHF)的住院治疗涉及大量发病率和死亡率。当前的管理策略具有主要局限性,并且在新疗法的开发方面进展甚微。鉴于精氨酸加压素受体拮抗剂促进利尿的能力,它们可能在ADHF的治疗中具有前途。这项初步研究旨在评估静脉用康尼普坦(双重精氨酸加压素V(1A)/ V(2)-受体拮抗剂)治疗ADHF的疗效和安全性。方法和结果:在一项双盲,多中心试验中,将170名因心力衰竭加重住院并接受标准治疗的患者随机分配接受康尼普坦治疗(20毫克负荷剂量,然后连续2次连续24小时连续输注40、80 ,或120 mg / d)或安慰剂。康尼伐坦和安慰剂组在48小时的患者或临床医生对总体和呼吸状况的评估中没有显着差异。没有证据表明任何组的心力衰竭都会恶化。每种剂量的Conivaptan在24小时时的尿量显着高于安慰剂(P <或= .02),差异平均为1.0至1.5L。Conivaptan 40和80 mg / d的平均体重降低(约1-2)公斤)与尿量增加平行,但未达到统计学意义。 Conivaptan具有良好的耐受性,与生命体征,电解质紊乱或心律的临床重要变化无关。最常见的不良事件是输注部位反应。结论:当将康尼普坦添加到ADHF的标准疗法中时,可以安全地改善尿量。可能有必要对该化合物在ADHF中进行进一步研究,尤其是考虑到该综合征目前治疗的局限性。

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