Vasopressin receptor antagonists in the management of acute heart failure

摘要

Vasopressin is a potent vasoconstrictor and plays a significant role in the regulation of volume homeostasis.Several non-peptide vasopressin receptor antagonists(vaptans)have emerged as promising drugs in the management of acute heart failure.Results of early trials with tolvaptan(selective vasopressin subtype 2 receptor antagonist)and conivaptan(dual vasopressin subtypes 1a and 2 receptor antagonist)have demonstrated improvement in the fluid status,osmotic balance and haemodynamic profile in patients with heart failure presenting with signs and symptoms of decompensation.Nevertheless,their comparative long-term safety and efficacy remains to be determined in large-scale clinical trials.