Tolvaptan Therapy in Heart Failure Management
Summary
Heart failure is characterised by neurohormonal activation leading to sodium and water retention, congestion and hyponatraemia. Tolvaptan, a selective vasopressin V2 receptor antagonist, promotes aquaresis—excretion of free water without significant sodium loss—thereby relieving volume overload while preserving renal function. In acute settings, early administration of tolvaptan enhances diuretic response, accelerates relief of dyspnoea and reduces the risk of worsening renal function. In chronic heart failure, add-on tolvaptan improves long-term fluid balance and mitigates hyponatraemia, which is an independent predictor of morbidity and mortality. The therapy has global relevance, offering a strategic complement to conventional loop diuretics, especially in patients with renal impairment or refractory congestion. Practical applications span acute decompensation, postoperative fluid management and prevention of re-hospitalisation, underscoring its role in personalised fluid-management protocols across diverse healthcare settings.
Research from Nature Portfolio
No recent Nature Portfolio content available.
Tolvaptan Therapy in Heart Failure Management publication trend
The graph below shows the total number of articles in tolvaptan therapy in heart failure management across all publications each year (not limited to Nature Index journals).
Technical terms
Vasopressin V2 receptor antagonist: Compound that blocks V2 receptors in the renal collecting duct to inhibit water reabsorption.
Aquaresis: Excretion of free water without electrolyte loss, reducing fluid overload.
Diuretic response: The degree of fluid removal and symptomatic improvement achieved by a diuretic regimen.
Hyponatraemia: A state of abnormally low serum sodium concentration often seen in heart failure.
References
- Tolvaptan for water retention in heart failure: a systematic review. Systematic Reviews (2023).
- Tolvaptan add‐on therapy in patients with acute heart failure: A systematic review and meta‐analysis. Pharmacology Research & Perspectives (2020).
- Early treatment with tolvaptan improves diuretic response in acute heart failure with renal dysfunction. Clinical Research in Cardiology (2017).
About these summaries
This Nature Research Intelligence Topic summary is created with the cited references and a large language model. We take care to ground generated text with facts, and have systems in place to gain human feedback on the overall quality of the process in line with our AI principles. We strive to create accurate and useful summaries for people unfamiliar with the research topic and that supports this goal. These pages are a beta release and will be updated as we learn how best to help people gain value from a research topic summary.
Turn complex research questions into confident strategic decisions
When you're under pressure to set direction, justify investment, or understand your competitive position, you need more than raw data — you need trusted insights you can act on.
Benchmark your performance against global peers using robust, methodologically sound analysis.
Combine quantitative metrics with qualitative expert insight to uncover strengths, gaps and emerging opportunities.
Gain tailored, decision-ready recommendations aligned to your strategic priorities.
Talk to us to learn more about our data dashboards and bespoke strategy reports.
Grow research skills, confidence and careers with training built for every stage of the research lifecycle.
Developed with Nature Portfolio journal Editors and internationally renowned experts. Discover three ways to learn:
Self-paced, online courses in convenient bite-sized units, covering key skills across scientific writing, publishing, grant writing, data analysis, and more.
Expert trainer-led workshops with hands-on exercises and real-time feedback across core research skills, delivered via interactive group sessions.
Editor-led workshops combining core principles in writing and publishing, personalised 1:1 feedback from Nature Portfolio Editors and hands-on exercises.
Explore course catalogues and workshop agendas, enquire about the options or request institutional pricing.