For acute decompensated heart failure (ADHF) therapy, combination of carperitide, a human atrial natriuretic peptide, and tolvaptan, a novel vasopressin type 2 receptor antagonists, has not been used. Tolvaptan is a drug newly developed to treat volume overload in ADHF patients. Of 102 consecutive cases treated upon admission for ADHF between April and October 2012, we analyzed 51 patients treated with carperitide plus tolvaptan (tolvaptan +carperitide group) and 51 patients treated with

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... tide plus conventional diuretics (carperitide group). On comparison between both groups, total dose of carperitide and loop diuretic doses during 48 h in tolvaptan +carperitide group were lower than those in the carperitide group (both p<0.001). Urine output at 24 h and 48 h after admission in the tolvaptan+carperitide group were significantly higher than those in carperitide group (p=0.02 and p<0.001, respectively). Changes in NT-pro brain-type natriuretic peptide levels in tolvaptan+carperitide group were significantly higher than those in carperitide group (p=0.01). No significant differences were detected in worsening renal function. On conclusion, in ADHF therapy, coadministration of tolvaptan and carperitide was more effective and safe compared with conventional therapy.