Abnormalities of sodium handling and of cardiovascular adaptations during high salt diet in patients with mild heart failure
Autor: | Massimo Volpe, Tritto, C., Deluca, N., Rubattu, S., Rao, M. A. E., Lamenza, F., Mirante, A., Enea, I., Rendina, V., Mele, A. F., Trimarco, B., Condorelli, M. |
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Přispěvatelé: | Volpe, M, Tritto, C, DE LUCA, Nicola, Rubattu, S, Rao, Ma, Lamenza, F, Mirante, A, Enea, I, Rendina, V, Mele, Af |
Rok vydání: | 1993 |
Předmět: |
Male
medicine.medical_specialty Heart disease Natriuresis Plasma renin activity Renin-Angiotensin System chemistry.chemical_compound Atrial natriuretic peptide Physiology (medical) Internal medicine medicine Humans Sodium Chloride Dietary Heart Failure Ejection fraction Aldosterone business.industry Hemodynamics Dilated cardiomyopathy Stroke volume Middle Aged medicine.disease Adaptation Physiological Forearm Endocrinology chemistry Echocardiography Regional Blood Flow Heart failure Female Cardiology and Cardiovascular Medicine business Atrial Natriuretic Factor |
Zdroj: | Scopus-Elsevier |
ISSN: | 1524-4539 0009-7322 |
Popis: | BACKGROUND Sodium retention and hormonal activation are fundamental hallmarks in congestive heart failure. The present study was designed to assess the ability of patients with asymptomatic to mildly symptomatic heart failure and no signs or symptoms of congestion to excrete ingested sodium and to identify possible early abnormalities of hormonal and hemodynamic mechanisms related to sodium handling. METHODS AND RESULTS The effects of a high salt diet (250 mEq/day for 6 days) on hemodynamics, salt-regulating hormones, and renal excretory response were investigated in a balanced study in 12 untreated patients with idiopathic or ischemic dilated cardiomyopathy and mild heart failure (NYHA class I-II, ejection fraction < 50%) (HF) and in 12 normal subjects, who had been previously maintained a 100 mEq/day NaCl diet. In normal subjects, high salt diet was associated with significant increases of echocardiographically measured left ventricular end-diastolic volume, ejection fraction, and stroke volume (all P < .001) and with a reduction of total peripheral resistance (P < .001). In addition, plasma atrial natriuretic factor (ANF) levels increased (P < .05), and plasma renin activity and aldosterone concentrations fell (both P < .001) in normals in response to salt excess. In HF patients, both left ventricular end-diastolic and end-systolic volumes increased in response to high salt diet, whereas ejection fraction and stroke volume failed to increase, and total peripheral resistance did not change during high salt diet. In addition, plasma ANF levels did not rise in HF in response to salt loading, whereas plasma renin activity and aldosterone concentrations were as much suppressed as in normals. Although urinary sodium excretions were not significantly different in the two groups, there was a small but systematic reduction of daily sodium excretion in HF, which resulted in a significantly higher cumulative sodium balance in HF than in normals during the high salt diet period (P < .001). CONCLUSIONS These results show a reduced ability to excrete a sodium load and early abnormalities of cardiac and hemodynamic adaptations to salt excess in patients with mild heart failure and no signs or symptoms of congestion. |
Databáze: | OpenAIRE |
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