Analysis Of The Efficacy Of Tolvaptan In The Treatment Of Heart Failure With Preserved Ejection Fraction

Background:Heart failure(HF)is the terminal stage of all kinds of heart disease.With the aging of the population,the prevalence of HF is getting higher and higher.According to the classification of left ventricular ejection fraction,HF includes heart failure with reduced ejection fraction(HFr EF),heart failure with mid-range ejection fraction(HFmr EF)and heart failure with preserved ejection fraction(HFpEF).HFpEF is a common type of heart failure,accounting for about half of the population.However,there are few drugs that can reduce the mortality of HFpEF,so it is particularly important to relieve the symptoms of HF early and improve the quality of life.Tolvaptan is an angiotensin V2 receptor blocker that reduces symptoms of HFr EF early during hospitalization.However,there are few studies on the therapeutic effect of Tolvaptan on HFpEF.In this paper,the efficacy of Tolvaptan in the treatment of HFpEF was analyzed.Purpose:To explore the degree of symptom relief in patients with HFpEF treated with Tolvaptan,and its effect on electrolytes,renal function,length of stay and 30-day readmission rates of HFMethods:64 patients with HFpEF in the first affiliated Hospital of Henan University from January 2019 to November 2020 were divided into two groups: traditional + Tolvaptan treatment group and traditional treatment group.The changes of electrolyte,relief of HF symptoms and signs,body weight,urine volume,systolic blood pressure,heart rate,renal function,Length of stay and readmission rate due to HF30 days were compared between the two groups.Results:1.A total of 64 people were enrolled in this experiment,all of them were HFpEF(LVEF ≥ 50%),32 in traditional treatment group and 32 in Tolvaptan treatment group,and there were no significant differences in sex,age,heart rate,systolic blood pressure,body weight,medical history,oral drugs,loop diuretic and laboratory examination before entering the group.2.The serum sodium and chloride in the traditional treatment group decreased significantly at 48 hours and 5 days,while those in the Tolvaptan group increased significantly at 48 hours and 5 days.There was a significant difference in the changes of serum sodium and chloride between the two groups(p < 0.05),but there was no significant difference in serum potassium between the two groups(p > 0.05).3.The remission of symptoms and signs of HF3.1 The dyspnea was significantly improved at 12 hours and 24 hours after entering the Tolvaptan group and the traditional treatment group,and the improvement in the tolvaptan group was significantly better than that in the traditional treatment group,and the difference was with statistical significant(p < 0.05).3.2 The edema symptoms of both lower limbs,lung rale and jugular vein filling were improved after 48 hours in the Tolvaptan group and the traditional treatment group,but the symptom relief was more obvious in the HF patients in the tolvaptan group,and there was a significant difference between the two groups(p < 0.05).4.The urine volume increased and the body weight decreased continuously 24 hours and 5 days after admission in the tolvaptan group and the traditional treatment group,and the change in the tolvaptan group was larger than that in the traditional treatment group,and the difference was statistically significant(p < 0.05).5.The systolic blood pressure and heart rate changes of the two groups were similar at 48 hours and 5 days after entering the group in the Tolvaptan group and the traditional treatment group,and there was no significant difference between the two groups.6、Five days after entering the group,the levels of blood urea nitrogen,serum creatinine and NT-pro BNP in the Tolvaptan group decreased significantly,while those in the traditional treatment group increased significantly,and there was a significant difference in the changes of blood urea nitrogen,serum creatinine and NT-pro BNP between the two groups(p < 0.05).7、The length of hospital stay in the Tolvaptan group was significantly shorter than that in the traditional treatment group,and the difference was statistically significant(p<0.05),and the 30-day readmission rate in the Tolvaptan group was significantly lower than that in the traditional treatment group,and there was a significant statistical difference between the two groups(p<0.05).Conclusion:In the treatment of patients with HFpEF,Tolvaptan can increase serum sodium and serum chloride early,relieve the symptoms of dyspnea,increase urine volume,lose weight,protect renal function,and reduce the length of hospital stay and 30-day readmission rate,but have no significant effect on blood pressure and heart rate.