Prognostic importance of sodium level trajectory in acute heart failure
| Autor: | Sho Torii, Yuichi Ono, Seiji Fukamizu, Kazuki Yoshida, Satoshi Yamaguchi, Steven R. Goldsmith, Takeshi Kitai, Toshihiko Nishioka, Makoto Noda, Yuya Matsue, Yasuhiro Satoh, Hiroyuki Fujii, Kenji Yoshioka, Makoto Suzuki, Kaoru Sugi, Yuko Onishi, Nobuyuki Kagiyama |
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| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty Time Factors Sodium medicine.medical_treatment Tolvaptan chemistry.chemical_element 030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine Japan Cause of Death Internal medicine medicine Clinical endpoint Humans Hospital Mortality 030212 general & internal medicine Intensive care medicine Aged Retrospective Studies Heart Failure Dose-Response Relationship Drug business.industry Benzazepines Vascular surgery Prognosis medicine.disease Cardiac surgery Survival Rate chemistry Heart failure Acute Disease Cardiology Female Diuretic Cardiology and Cardiovascular Medicine business Antidiuretic Hormone Receptor Antagonists Biomarkers Follow-Up Studies Hyponatremia medicine.drug Low sodium |
| Zdroj: | Heart and Vessels. 32:1498-1505 |
| ISSN: | 1615-2573 0910-8327 |
| DOI: | 10.1007/s00380-017-1020-5 |
| Popis: | Low sodium levels are strongly associated with poor prognosis in acute heart failure (AHF); however, the prognostic impact of the sodium level trajectory overtime has not been determined. A secondary analysis of the AQUAMARINE study in which patients with AHF and renal impairment were randomized to receive either tolvaptan or conventional treatment was performed. Sodium levels were evaluated at the baseline and at 6, 12, 24, and 48 h. We defined 'sodium dipping' as sodium level falling below the baseline level at any time point. The primary endpoint was the combined event of all-cause death and heart failure rehospitalization during follow-up. The analysis included 184 patients with a median follow-up of 21.1 months. Sodium levels more steeply increased during the 48 h in patients without events as compared to sodium levels in patients with events (P = 0.018 in linear-mixed effect model). The sodium dipping group (n = 100; 54.3%) demonstrated significantly less urine output, less body weight reduction, and poorer diuretic response within 48 h compared to the non-dipping group. The sodium dipping group was also significantly associated with a low combined-event-free survival after adjustment for other prognostic factors (HR 1.97; 95% CI 1.06-3.38; P = 0.033). The trajectory of sodium levels during the acute phase is associated with the prognosis of patients with AHF independently of the baseline sodium level. |
| Databáze: | OpenAIRE |
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