Tanaka N, Dan K, Maeda T, et al. - In cases of acute decompensated heart failure (HF), feasibility of early and short-term administration of tolvaptan was evident and this treatment approach provided a more rapid improvement along with reduced health-care costs.

• In previous trials, tolvaptan was shown to improve acute HF.

• 201 acute decompensated HF cases were prospectively assessed, and were randomly split into 2 groups on the basis of timing of tolvaptan start.

• Patients in the early group were given tolvaptan about 1 week after day 1 or 2 (n = 104), whereas the late group was given the same drug 1 week after the early group (n = 97).

• Follow-up revealed comparable all-cause mortality, cardiovascular death, and hospitalization between groups.

• Not only shorter durations of oxygenation, carperitide infusion, and hospitalization but also a significantly faster reduction in pleural effusion was seen in the early group vs the late group.

• Significantly less expenses on diuretics and on tolvaptan and carperitide occurred in the early group vs the late group.