Circulation Journal
Online ISSN : 1347-4820
Print ISSN : 1346-9843
ISSN-L : 1346-9843
Heart Failure
Low-Normal Serum Sodium and Heart Failure-Related Events in Patients With Heart Failure With Preserved Left Ventricular Ejection Fraction
Hiroaki KusakaSeigo SugiyamaEiichiro YamamotoEiichi AkiyamaYasushi MatsuzawaYoshihiro HirataKoichiro FujisueHirofumi KurokawaJunichi MatsubaraKoichi SugamuraHirofumi MaedaHideaki JinnouchiKunihiko MatsuiHisao Ogawa
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Supplementary material

2016 Volume 80 Issue 2 Pages 411-417

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Abstract

Background:Hyponatremia has been shown to be a prognostic factor in heart failure (HF) with preserved ejection fraction (HFpEF). Serum sodium (sNa) cut-off, however, is not defined in HFpEF. Therefore, we investigated the relationship between sNa and HF-related events (cardiovascular death and hospitalization for HF decompensation) in HFpEF patients.Methods and Results:We assessed cardiac function using echocardiography and measured sNa in HFpEF patients with New York Heart Association class II (n=321) or III (n=84) in a compensated condition after implementing medical therapy for HF. During a mean follow-up of 27 months, 73 patients developed HF-related events. On multivariate Cox hazard analysis including established predictors in HF, sNa level as a continuous variable was identified as an independent predictor for HF-related events in HFpEF (per 1.0 mmol/L: HR, 0.93; 95% CI: 0.87–0.98; P<0.01). Kaplan-Meier analysis demonstrated significantly higher probability of HF-related events in the lower sNa group (sNa <140 mmol/L) than in the higher sNa group (sNa ≥140 mmol/L; P<0.001, log-rank test). Further, the low-normal sNa group (135 mmol/L<sNa<140 mmol/L) was significantly associated with HF-related events compared with the higher sNa group (P<0.001, log-rank test).Conclusions:sNa as a continuous variable was independently correlated with future HF-related events in HFpEF. Low-normal sNa could provide important prognostic information for practical risk stratification in HFpEF. (Circ J 2016; 80: 411–417)

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© 2016 THE JAPANESE CIRCULATION SOCIETY
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