Matsumura K, et al. – In this investigation—conducted in a real-world setting—researchers identified prognostic factors influencing long-term clinical outcomes in 263 retrospectively enrolled consecutive patients hospitalized for acute decompensated heart failure (ADHF) and treated with tolvaptan. The identified independent predictors of combined event occurrence within 1 year included change in serum sodium level between pre-treatment and 24 hours after tolvaptan administration and the time taken for tolvaptan initiation from admission. Overall, possible utility of increased serum sodium level early after administration and early initiation of tolvaptan was suggested for assessing the long-term prognosis after tolvaptan treatment in patients with ADHF.