Vasopressin In Heart Failure

The nonapeptide hormone vasopressin (VP), synthesized by the hypothalamic supraoptic and paraventricular nuclei, exerts important effects on cardiovascular system via its receptors V1, V2 and V3. Patients with congestive heart failure (CHF) present elevated plasma VP levels that induce vasoconstriction, left ventricular hypertrophy, and free water reabsorption that leads to edema and hyponatremia, markers of advanced CHF. Vaptans, antagonists of VP receptors, are able to increase urine output and plasma sodium levels without the increased risk of arrhythmic death induced by diuretics, even though, further studies are needed to establish a possible role of these drugs in the treatment of CHF. Aim of this paper is to review the role of vasopressin in CHF.