Abstract

vasopressin (AVP) in the development of hyponatremia in

patients with heart failure (HF), the role of diuretics, and

the potential for vasopressin-receptor antagonists in the

treatment of HF.

identify articles relating to HF, diuretics, hyponatremia,

AVP, and vasopressin-receptor antagonists.

United States and is associated with substantial cost,

morbidity, and mortality. One of the complications associated

with HF, as well as with its treatment, is the development of

hyponatremia. Hyponatremia in patients with HF is associated

with poor outcomes and can limit the use of diuretic therapy.

AVP is the primary stimulus to the development of hyponatremia

in these patients and therapies that target AVP action

would seem a logical choice in the therapeutic regimen for HF.

primarily responsible for water resorption in the kidney, are

now available and have been studied in patients with HF.

These drugs have been associated with improvements in

serum sodium concentration, urine output, and body weight,

but have shown no long-term mortality benefit in patients

with HF. In a subset of patients with baseline hyponatremia,

these agents improved quality of life scores.

in the treatment of HF; however, the exact role of these

agents in the treatment of HF still requires further study.