Congestive heart failure therapeutic strategies

Chow MSS, Scheife RT, eds. Therapeutic and research strategies for congestive heart failure. Pharmacotherapy 1993 13 (5 pt 2) 71S-99. 

OTHER WATER-RETAINING STATES In patients with congestive heart failure, cirrhosis, or nephrotic syndrome, ejfective blood volume often is reduced, and hypovolemia frequently is exacerbated by the liberal use of diuretics. Since hypovolemia stimulates vasopressin release, patients may become hyponatremic owing to vasopressin-mediated retention of water. The development of potent orally active receptor antagonists and specific inhibitors of water chaimels in the collecting duct would provide an effective therapeutic strategy not only in patients with SIADH but also in the much more common setting of hyponatremia in patients with heart faftme, cirrhosis, or nephrotic syndrome. 

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