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J. Clin. Med. 2016, 5(10), 86; doi:10.3390/jcm5100086

Vasopressin Receptor Antagonists for the Correction of Hyponatremia in Chronic Heart Failure: An Underutilized Therapeutic Option in Current Clinical Practice?

1
Cardiology Unit, Presidio Sanitario Intermedio “Elena d’Aosta”, ASL Napoli 1 Centro, via Cagnazzi 29, 80137 Naples, Italy
2
Heart Department, Interventional Cardiology, Azienda Ospedaliero-Universitaria “San Giovanni di Dio e Ruggi d’Aragona”, via San Leonardo 1, 84131 Salerno, Italy
*
Author to whom correspondence should be addressed.
Academic Editor: Hemant Poudyal
Received: 12 August 2016 / Revised: 22 September 2016 / Accepted: 27 September 2016 / Published: 2 October 2016
View Full-Text   |   Download PDF [205 KB, uploaded 2 October 2016]

Abstract

In the congestive heart failure (CHF) setting, chronic hyponatremia is very common. The present review aims at addressing topics relevant to the pathophysiology of hyponatremia in the course of CHF as well as its optimal treatment, including the main advantages and the limitations resulting from the use of the available dietary and pharmacological measures approved for the treatment of this electrolytic trouble. A narrative review is carried out in order to represent the main modalities of therapy for chronic hyponatremia that frequently complicates CHF. The limits of usual therapies implemented for CHF-related chronic hyponatremia are outlined, while an original analysis of the main advancements achieved with the use of vasopressin receptor antagonists (VRAs) is also executed. The European regulatory restrictions that currently limit the use of VRAs in the management of CHF are substantially caused by financial concerns, i.e., the high costs of VRA therapy. A thoughtful reworking of current restrictions would be warranted in order to enable VRAs to be usefully associated to loop diuretics for decongestive treatment of CHF patients with hyponatremia. View Full-Text
Keywords: hyponatremia; chronic heart failure; vasopressin receptor antagonists hyponatremia; chronic heart failure; vasopressin receptor antagonists
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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MDPI and ACS Style

De Vecchis, R.; Cantatrione, C.; Mazzei, D.; Baldi, C. Vasopressin Receptor Antagonists for the Correction of Hyponatremia in Chronic Heart Failure: An Underutilized Therapeutic Option in Current Clinical Practice? J. Clin. Med. 2016, 5, 86.

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