Document Detail

Hyponatremia as a predictor for worsening heart failure in patients receiving cardiac resynchronization therapy.
MedLine Citation:
PMID:  23018767     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Various factors associated with worsening heart failure (HF) events have been investigated in HF subjects. The purpose of this study was to identify the predictive factor(s) for worsening HF events after cardiac resynchronization therapy (CRT) among baseline parameters, as well as baseline factors associated with responsiveness or non-responsiveness to CRT.
METHODS AND RESULTS: Seventy-seven HF patients with an indication for CRT were enrolled. Baseline parameters of blood chemistry, electrocardiogram, echocardiogram and cardiac catheterization before device implantation were measured, and subsequent clinical HF events after CRT were investigated. During the follow-up period (median 601 days), 22 of 77 (29%) recipients had HF events (unscheduled HF hospitalization: 16; use of left ventricular assist system: 1; heart transplantation: 1; cardiac death: 4). In the multivariate Cox proportional hazards model, low serum sodium concentration was associated with the occurrence of HF events after CRT (hazard ratio 0.82, 95% confidence interval 0.68-0.99, P=0.034). At baseline, serum sodium concentration negatively correlated with pulmonary capillary wedge pressure (r=-0.71, P<0.001) and with plasma arginine vasopressin level (r=-0.68, P=0.008).
CONCLUSIONS: Hyponatremia is an independent predictor for worsening HF events after CRT implantation, which may be partly explained by elevated level of plasma arginine vasopressin.
Kenshiro Arao; Takayuki Fujiwara; Kenichi Sakakura; Hiroshi Wada; Yoshitaka Sugawara; Chikashi Suga; Junya Ako; San-e Ishikawa; Shin-ichi Momomura
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Publication Detail:
Type:  Clinical Trial; Journal Article     Date:  2012-09-28
Journal Detail:
Title:  Circulation journal : official journal of the Japanese Circulation Society     Volume:  77     ISSN:  1347-4820     ISO Abbreviation:  Circ. J.     Publication Date:  2013  
Date Detail:
Created Date:  2013-01-07     Completed Date:  2013-06-13     Revised Date:  2013-07-08    
Medline Journal Info:
Nlm Unique ID:  101137683     Medline TA:  Circ J     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  116-22     Citation Subset:  IM    
Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan.
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MeSH Terms
Arginine Vasopressin / blood
Cardiac Resynchronization Therapy*
Follow-Up Studies
Heart Failure / blood,  physiopathology,  therapy*
Hyponatremia* / blood,  etiology,  physiopathology
Middle Aged
Predictive Value of Tests
Risk Factors
Sodium / blood
Reg. No./Substance:
113-79-1/Arginine Vasopressin; 7440-23-5/Sodium
Comment In:
Circ J. 2013;77(1):47-8   [PMID:  23183642 ]

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