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Relation between serum sodium levels and prognosis in outpatients with chronic heart failure: neutral effect of treatment with beta-blockers and angiotensin-converting enzyme inhibitors: data from the Italian network on congestive heart failure (IN-CHF database).
MedLine Citation:
PMID:  21873881     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
INTRODUCTION: The predictive role of hyponatremia has been tested in acute and chronic heart failure. Sodium level is inversely related with renin-angiotensin-aldersterone system (RAAS) and sympathetic nervous activity but important issues remain unresolved. Our aim was to define the level of hyponatremia able to predict 1-year outcomes and investigate the relation between sodium levels and mortality and the effect of beta-blockers and angiotensin-converting enzyme (ACE) inhibitors on this relation. METHODS: We analyzed 4670 patients enrolled in the IN-CHF Italian Registry. We controlled the predictivity of hyponatremia, testing it either as a continuous variable and dividing the study sample into three severity groups: group 1 (≥136 mEq/l; n = 4207), group 2 (131-135 mEq/l; n = 389) and group 3 (≤130 mEq/l; n = 74). The linearity of the relationship between sodium levels and mortality was also tested. RESULTS: Mild-to-moderate and severe hyponatremia (groups 2 and 3) independently predicted the 1-year mortality. The relation between sodium concentration and death was not linear and a decrease of 1 mEq/l of sodium increased death rate only for values of sodium 142.9 mEq/l or less. This relationship was not modified by beta-blocker and ACE inhibitor therapies. CONCLUSION: Our data confirm the negative prognostic value of hyponatremia, even of moderate degree, independently of the use of recommended treatments for heart failure.
Authors:
Samuele Baldasseroni; Renato Urso; Francesco Orso; Bianca P Bianchini; Emanuele Carbonieri; Antonio Cirò; Lucio Gonzini; Giuseppe Leonardi; Niccolò Marchionni; Aldo P Maggioni;
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-8-25
Journal Detail:
Title:  Journal of cardiovascular medicine (Hagerstown, Md.)     Volume:  -     ISSN:  1558-2035     ISO Abbreviation:  -     Publication Date:  2011 Aug 
Date Detail:
Created Date:  2011-8-29     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101259752     Medline TA:  J Cardiovasc Med (Hagerstown)     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
aSection of Geriatric Cardiology, Department of Heart and Vessels, University School of Medicine, Florence and Careggi Hospital bANMCO Research Center, Florence cDepartment of Cardiology, Giovanni Bosco Hospital, Turin dDepartment of Cardiology, Orlandi Hospital, Bussolengo eDepartment of Cardiology, San Gerardo Hospital, Monza fHeart Failure Unit, Ferrarotto-Alessi Hospital, Catania, Italy *A complete list of participating centers and investigators is given at the end of the paper.
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