Objective To explore the clinical efficacy and safety of tolvaptan in elderly patients with refractory heart failure.

Methods Three hundred patients with refractory heart failure were selected as the research subjects, and randomly divided into the control group (conventional treatment, n = 150) and observation group (treated with tolvaptan on the basis of the control group, n = 150) according to the principle of random grouping. The clinical efficacy and adverse reactions in two groups were observed, the left ventricular ejection fraction (LVEF), N-terminal pro-B-type natriuretic peptide (NT-proBNP), serum blood urea nitrogen (BUN)/creatinine (Cr) value, 6-minute walk test (6MWT) and Minnesota Heart Failure Quality of Life Questionnaire (MLHFQ) score in two groups were compared before and after treatment.

Results The total effective rate of treatment in the observation group was 98.00%, which was higher than 92.67% in the control group (P ＜ 0.05). The adverse reaction rates of two groups were relatively low, and the difference was not statistically significant (P ＞ 0.05). Before treatment, there was no statistically significant differences in the LVEF, NT-proBNP, BUN/Cr values, 6MWT and MLHFQ scores between two groups (P ＞ 0.05). After treatment, all the above indicators were improved in two groups, and the improvement in the observation group was better than that in the control group (P ＜ 0.05 to P ＜ 0.01).

Conclusions Tolvaptan has good clinical effects in the treatment of refractory heart failure in elderly patients. It can effectively increase the LVEF level, reduce the BUN/Cr and NT-proBNP indicators, improve the quality of life, and has high safety. It is worthy of promotion.