Clinical and Hemodynamic Effects of Simple Add-on Tolvaptan Therapy and Their Predictors in Patients with Heart Failure

function (WRF, an increase in serum creatinine by O0.3 mg/dl from baseline) in early phase remains insufficiently evaluated. Methods: We retrospectively investigated the predictors of WRF within 24 hours in 80 patients admitted for ADHF and treated by pulmonary artery catheter-guided therapy between January 2006 and July 2007 (mean age, 78.4610.9 years). Result: WRF within 24 hours occurred in 9 patients (11.3%). There were no significant differences between patients with and without WRF in left ventricular ejection fraction (41.369.4% vs. 41.4612.6%, p50.98), pulmonary capillary wedge pressure (22.368.8 mmHg vs. 18.268.3 mmHg, p50.25), and cardiac index (3.361.3 l/min/m vs. 2.961 l/min/ m, p50.3) on admission. By multivariate adjustment analysis, independent predictors of WRF within 24 hours were serum creatinine on admission (odds ratio, 7.1; 95% confidence interval, 2.2-33.9; p50.0007), men (odds ratio, 11.2; 95% confidence interval, 1.3-307.9; p50.024), and central venous pressure on admission (odds ratio, 1.3; 95% confidence interval, 1.1-1.6; p50.006). Conclusions: Central venous pressure on admission is an independent predictors of WRF in early phase, while other hemodynamic parameters on admission were not.