Prospective Study
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jun 7, 2016; 22(21): 5104-5113
Published online Jun 7, 2016. doi: 10.3748/wjg.v22.i21.5104
Usefulness of portal vein pressure for predicting the effects of tolvaptan in cirrhotic patients
Ai Nakagawa, Masanori Atsukawa, Akihito Tsubota, Chisa Kondo, Tomomi Okubo, Taeang Arai, Norio Itokawa, Yoshiyuki Narahara, Katsuhiko Iwakiri
Ai Nakagawa, Masanori Atsukawa, Chisa Kondo, Tomomi Okubo, Taeang Arai, Norio Itokawa, Division of Gastroenterology, Department of Internal Medicine, Nippon Medical School Chiba Hokusoh Hospital, Chiba 270-1694, Japan
Akihito Tsubota, Core Research Facilities for Basic Science, Research Center for Medical Sciences, Jikei University School of Medicine, Tokyo 105-8471, Japan
Yoshiyuki Narahara, Katsuhiko Iwakiri, Division of Gastroenterology, Department of Internal Medicine, Nippon Medical School, Tokyo 113-8603, Japan
Author contributions: Nakagawa A, Atsukawa M, Kondo C, Okubo T, Arai T and Itokawa N designed the study and measured porta vein pressure; Atsukawa M and Tsubota A contributed equally to the preparation of this manuscript; Tsubota A, Narahara Y and Iwakiri K supervised the study; all authors have read and approved the final version to be published.
Institutional review board statement: The protocol was approved by the Ethics Review Board of Nippon Medical School Chiba Hokusoh Hospital (approval No. 526012). All patients and their families received a sufficient explanation of the aim and contents of this study before the entry.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Informed consent statement: All patients and their families received a sufficient explanation of the aim and contents of this study before the entry. Patients who provided written informed consent participated in this study. All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation and with Helsinki Declaration of 1975, as revised in 2008.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Masanori Atsukawa, MD, PhD, Department of Internal Medicine, Division of Gastroenterology, Nippon Medical School Chiba Hokusoh Hospital, 1715, Kamakari, Inzai, Chiba 270-1694, Japan. momogachi@yahoo.co.jp
Telephone: +81-4-76991111 Fax: +81-4-769911111908
Received: February 23, 2016
Peer-review started: February 23, 2016
First decision: March 7, 2016
Revised: March 19, 2016
Accepted: March 30, 2016
Article in press: March 30, 2016
Published online: June 7, 2016
Core Tip

Core tip: To clarify the factors influencing the effect of tolvaptan, a V2 receptor antagonist, in patients with decompensated liver cirrhosis complicated by liquid retention, we conducted this study. As a result, hepatic venous pressure gradient (HVPG) was the only significant factor that influenced the weight loss effect of tolvaptan. The response rate was 87.5% (7/8) in patients with HVPG of 190 mmH2O or less, whereas it was only 12.5% (2/16) in those with HVPG of greater than 190 mmH2O. The present study suggests that tolvaptan in the treatment of liquid retention related to decompensated liver cirrhosis could be more effective for patients with lower portal vein pressure.