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Su Y, Ma M, Zhang H, Pan X, Zhang X, Zhang F, Lv Y, Yan C. Prognostic value of serum hyponatremia for outcomes in patients with heart failure with preserved ejection fraction: An observational cohort study. Exp Ther Med 2020; 20:101. [PMID: 32973950 PMCID: PMC7507018 DOI: 10.3892/etm.2020.9231] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 07/01/2020] [Indexed: 12/14/2022] Open
Abstract
Hyponatremia is a risk factor associated with poor prognosis in patients with heart failure (HF) with reduced ejection fraction. However, whether hyponatremia has a similar role in patients with HF with preserved ejection fraction (HFpEF) has remained controversial. Therefore, the present study aimed to investigate the clinical characteristics and 24-month prognostic profile of a cohort of patients with HFpEF in China. From a registered observational cohort study on 1,027 subjects with HF, 496 patients with HFpEF were included. The association between baseline hyponatremia on admission and 24-month adverse outcomes (including all-cause mortality, re-hospitalization for HF and stroke) was analyzed using logistic regression with the Cox proportional hazards model. Of the 496 patients with HFpEF with a mean age of 72.8 years and proportion of males of 53.0%, 71 patients were diagnosed with hyponatremia. Furthermore, 29 patients (5.8%) were lost to follow-up. The hyponatremia group had lower blood pressure and serum hemoglobin, higher N-terminal pro B-type natriuretic peptide (NT-proBNP) and D-dimer, more patients with a history of atrial fibrillation and a higher proportion of spironolactone and loop diuretic use. According to a multivariate regression analysis, New York Heart Association functional classes III-IV and a serum NT-proBNP level above the median were risk factors for hyponatremia, while higher systolic blood pressure and β-blocker use were protective factors against hyponatremia. In the Kaplan-Meier analysis, hyponatremia was associated with all-causes of mortality, re-hospitalization for HF and a poor prognosis for patients suffering from strokes (log-rank P<0.05 for all 3 endpoints). On multivariate logistic regression analysis with the Cox proportional hazard model, hyponatremia was an independent predictor of three adverse outcomes [all-cause mortality: Hazard ratio (HR)=1.54, 95% CI=1.07-2.91, P=0.034; re-hospitalization for heart failure: HR=1.28, 95% CI=1.16-2.47, P=0.013; stroke: HR=1.78, 95% CI=1.04-2.89, P=0.016]. Collectively, the present results suggested that hyponatremia on admission was significantly associated with all-cause mortality, re-hospitalization and stroke within 24 months in a cohort of hospitalized patients with HFpEF in China. Thus, hyponatremia should be carefully monitored and frequently adjusted in patients with HFpEF (NCT04062500).
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Affiliation(s)
- Yang Su
- Department of Cardiology, Shanghai Tenth People's Hospital, Qidong People's Hospital, Tongji University School of Medicine, Shanghai 200072, P.R. China
| | - Mengqiu Ma
- Department of Cardiology, Shanghai Tenth People's Hospital, Qidong People's Hospital, Tongji University School of Medicine, Shanghai 200072, P.R. China
| | - Hengbin Zhang
- Department of Cardiology, Shanghai Tenth People's Hospital, Qidong People's Hospital, Tongji University School of Medicine, Shanghai 200072, P.R. China
| | - Xin Pan
- Department of Geriatrics, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, P.R. China
| | - Xianling Zhang
- Department of Cardiology, Shanghai Tenth People's Hospital, Qidong People's Hospital, Tongji University School of Medicine, Shanghai 200072, P.R. China
| | - Fenglei Zhang
- Department of Cardiology, Shanghai Yoda Cardiothoracic Hospital, Shanghai 200012, P.R. China
| | - Yangbo Lv
- Department of Cardiology, Shanghai Tenth People's Hospital, Qidong People's Hospital, Tongji University School of Medicine, Shanghai 200072, P.R. China.,Department of Cardiology, Shanghai Yoda Cardiothoracic Hospital, Shanghai 200012, P.R. China
| | - Chunxi Yan
- Department of Cardiology, Shanghai Tenth People's Hospital, Qidong People's Hospital, Tongji University School of Medicine, Shanghai 200072, P.R. China
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Vaidya GN, Salgado BC, Badar F, John A, Stoddard MF. Two‐dimensional strain echocardiography‐derived left ventricular ejection fraction, volumes, and global systolic dyssynchrony index: Comparison with three‐dimensional echocardiography. Echocardiography 2019; 36:1054-1065. [DOI: 10.1111/echo.14362] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 03/28/2019] [Accepted: 04/16/2019] [Indexed: 12/13/2022] Open
Affiliation(s)
- Gaurang Nandkishor Vaidya
- Department of Medicine Division of Cardiovascular Medicine University of Louisville Louisville Kentucky
| | - Benjamin C. Salgado
- Department of Medicine Division of Cardiovascular Medicine University of Louisville Louisville Kentucky
| | - Faraz Badar
- Department of Medicine Division of Cardiovascular Medicine University of Louisville Louisville Kentucky
| | - Anub John
- Department of Medicine Division of Cardiovascular Medicine University of Louisville Louisville Kentucky
| | - Marcus F. Stoddard
- Department of Medicine Division of Cardiovascular Medicine University of Louisville Louisville Kentucky
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