Hyponatraemia and its prognosis in acute heart failure is related to right ventricular dysfunction
ObjectivesHyponatraemia is a well-known predictor of clinical outcomes in heart failure (HF). However, the mechanism remains poorly understood. Previous reports suggest that hyponatraemia is related to right HF. We sought to evaluate the association between right ventricular (RV) dysfunction and hyp...
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| Veröffentlicht in: | Heart (British Cardiac Society) 2018-10, Vol.104 (20), p.1670-1677 |
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| creator | Lee, Heesun Lee, Sang Eun Park, Chan Soon Park, Jin Joo Lee, Ga Yeon Kim, Min-Seok Choi, Jin-Oh Cho, Hyun-jai Lee, Hae-Young Choi, Dong-Ju Jeon, Eun-Seok Kim, Jae-Joong Oh, Byung-Hee |
| description | ObjectivesHyponatraemia is a well-known predictor of clinical outcomes in heart failure (HF). However, the mechanism remains poorly understood. Previous reports suggest that hyponatraemia is related to right HF. We sought to evaluate the association between right ventricular (RV) dysfunction and hyponatraemia, and the impact of this relationship on the prognosis of patients with acute heart failure (AHF).MethodsThis is a nested case–control study of the Korean Acute Heart Failure registry. Among 2935 AHF patients enrolled prospectively and consecutively at four tertiary hospitals in Korea from 2011 to 2014, 116 patients with severe persistent hyponatraemia, defined as serum sodium level |
| doi_str_mv | 10.1136/heartjnl-2017-312084 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1957493484</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1957493484</sourcerecordid><originalsourceid>FETCH-LOGICAL-b375t-77ceac3b0636f04dd21bd16fb81e968ee72e209c7945b5bcd91eafdb02b87d653</originalsourceid><addsrcrecordid>eNqNkctKJTEQhsPg4G18g0ECbty0J-mkk85SxBsIs5mB2YVcqjWH7vQxSQvn7e1z0YUrV1VUffVXUT9Cvym5opSJxQuYVJaxr2pCZcVoTVr-Ax1TLtpN6f_BnLOmqQRh8gid5LwkhHDVikN0VCsilWDsGNmH9WqMpiQDQzDYRI9DyXiVxuc45pBxiNi4qQDe7sOdCf2UAM-dBL0p4HEZcQrPLwW_QSwpuKk3Cft17qboShjjL_SzM32Gs308Rf_ubv_ePFRPf-4fb66fKstkUyopHRjHLBFMdIR7X1PrqehsS0GJFkDWUBPlpOKNbazzioLpvCW1baUXDTtFlzvd-fjXCXLRQ8gO-t5EGKesqWokV4y3fEYvvqDLcUpxvk7XlDaUcboV5DvKpTHnBJ1epTCYtNaU6I0H-sMDvfFA7zyYx8734pMdwH8OfTx9BhY7wA7L70m-A_F_lVY</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2115134165</pqid></control><display><type>article</type><title>Hyponatraemia and its prognosis in acute heart failure is related to right ventricular dysfunction</title><source>PubMed Central</source><creator>Lee, Heesun ; Lee, Sang Eun ; Park, Chan Soon ; Park, Jin Joo ; Lee, Ga Yeon ; Kim, Min-Seok ; Choi, Jin-Oh ; Cho, Hyun-jai ; Lee, Hae-Young ; Choi, Dong-Ju ; Jeon, Eun-Seok ; Kim, Jae-Joong ; Oh, Byung-Hee</creator><creatorcontrib>Lee, Heesun ; Lee, Sang Eun ; Park, Chan Soon ; Park, Jin Joo ; Lee, Ga Yeon ; Kim, Min-Seok ; Choi, Jin-Oh ; Cho, Hyun-jai ; Lee, Hae-Young ; Choi, Dong-Ju ; Jeon, Eun-Seok ; Kim, Jae-Joong ; Oh, Byung-Hee</creatorcontrib><description><![CDATA[ObjectivesHyponatraemia is a well-known predictor of clinical outcomes in heart failure (HF). However, the mechanism remains poorly understood. Previous reports suggest that hyponatraemia is related to right HF. We sought to evaluate the association between right ventricular (RV) dysfunction and hyponatraemia, and the impact of this relationship on the prognosis of patients with acute heart failure (AHF).MethodsThis is a nested case–control study of the Korean Acute Heart Failure registry. Among 2935 AHF patients enrolled prospectively and consecutively at four tertiary hospitals in Korea from 2011 to 2014, 116 patients with severe persistent hyponatraemia, defined as serum sodium level <130 mmol/L at admission and <135 mmol/L before discharge, were matched with 232 controls, based on propensity scores for hyponatraemia. RV function was assessed with fractional area change (FAC) by echocardiography.ResultsRV dysfunction (FAC <35%) was more prevalent in patients with severe persistent hyponatraemia than in those without (81.0% vs 33.6%, p<0.001). Hyponatraemia was strongly associated with RV dysfunction (adjusted OR 8.00, 95% CI 4.50 to 14.22, p<0.001), but not with left ventricular dysfunction (adjusted OR 1.21, 95% CI 0.74 to 1.50, p=0.308). RV dysfunction was an independent predictor of all-cause mortality, after adjustment for hyponatraemia (adjusted HR 2.20, 95% CI 1.53 to 3.15, p<0.001), while hyponatraemia was not (adjusted HR 1.33, 95% CI 0.94 to 1.87, p=0.108).ConclusionsIn patients with AHF, hyponatraemia was more common with RV dysfunction. RV dysfunction, rather than hyponatraemia, was more significantly related with patients’ prognosis. Thus, the utility of RV dysfunction instead of hyponatraemia per se should be considered in HF risk models.Trial registration numberKorean Acute Heart Failure registry NCT01389843; Results.]]></description><identifier>ISSN: 1355-6037</identifier><identifier>EISSN: 1468-201X</identifier><identifier>DOI: 10.1136/heartjnl-2017-312084</identifier><identifier>PMID: 29079633</identifier><language>eng</language><publisher>England: BMJ Publishing Group LTD</publisher><subject>Cardiology ; Heart failure ; Medical diagnosis ; Medical prognosis ; Mortality ; Pulmonary arteries ; Pulmonary hypertension</subject><ispartof>Heart (British Cardiac Society), 2018-10, Vol.104 (20), p.1670-1677</ispartof><rights>Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.</rights><rights>2018 Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b375t-77ceac3b0636f04dd21bd16fb81e968ee72e209c7945b5bcd91eafdb02b87d653</citedby><cites>FETCH-LOGICAL-b375t-77ceac3b0636f04dd21bd16fb81e968ee72e209c7945b5bcd91eafdb02b87d653</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27903,27904</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29079633$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lee, Heesun</creatorcontrib><creatorcontrib>Lee, Sang Eun</creatorcontrib><creatorcontrib>Park, Chan Soon</creatorcontrib><creatorcontrib>Park, Jin Joo</creatorcontrib><creatorcontrib>Lee, Ga Yeon</creatorcontrib><creatorcontrib>Kim, Min-Seok</creatorcontrib><creatorcontrib>Choi, Jin-Oh</creatorcontrib><creatorcontrib>Cho, Hyun-jai</creatorcontrib><creatorcontrib>Lee, Hae-Young</creatorcontrib><creatorcontrib>Choi, Dong-Ju</creatorcontrib><creatorcontrib>Jeon, Eun-Seok</creatorcontrib><creatorcontrib>Kim, Jae-Joong</creatorcontrib><creatorcontrib>Oh, Byung-Hee</creatorcontrib><title>Hyponatraemia and its prognosis in acute heart failure is related to right ventricular dysfunction</title><title>Heart (British Cardiac Society)</title><addtitle>Heart</addtitle><description><![CDATA[ObjectivesHyponatraemia is a well-known predictor of clinical outcomes in heart failure (HF). However, the mechanism remains poorly understood. Previous reports suggest that hyponatraemia is related to right HF. We sought to evaluate the association between right ventricular (RV) dysfunction and hyponatraemia, and the impact of this relationship on the prognosis of patients with acute heart failure (AHF).MethodsThis is a nested case–control study of the Korean Acute Heart Failure registry. Among 2935 AHF patients enrolled prospectively and consecutively at four tertiary hospitals in Korea from 2011 to 2014, 116 patients with severe persistent hyponatraemia, defined as serum sodium level <130 mmol/L at admission and <135 mmol/L before discharge, were matched with 232 controls, based on propensity scores for hyponatraemia. RV function was assessed with fractional area change (FAC) by echocardiography.ResultsRV dysfunction (FAC <35%) was more prevalent in patients with severe persistent hyponatraemia than in those without (81.0% vs 33.6%, p<0.001). Hyponatraemia was strongly associated with RV dysfunction (adjusted OR 8.00, 95% CI 4.50 to 14.22, p<0.001), but not with left ventricular dysfunction (adjusted OR 1.21, 95% CI 0.74 to 1.50, p=0.308). RV dysfunction was an independent predictor of all-cause mortality, after adjustment for hyponatraemia (adjusted HR 2.20, 95% CI 1.53 to 3.15, p<0.001), while hyponatraemia was not (adjusted HR 1.33, 95% CI 0.94 to 1.87, p=0.108).ConclusionsIn patients with AHF, hyponatraemia was more common with RV dysfunction. RV dysfunction, rather than hyponatraemia, was more significantly related with patients’ prognosis. Thus, the utility of RV dysfunction instead of hyponatraemia per se should be considered in HF risk models.Trial registration numberKorean Acute Heart Failure registry NCT01389843; Results.]]></description><subject>Cardiology</subject><subject>Heart failure</subject><subject>Medical diagnosis</subject><subject>Medical prognosis</subject><subject>Mortality</subject><subject>Pulmonary arteries</subject><subject>Pulmonary hypertension</subject><issn>1355-6037</issn><issn>1468-201X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNqNkctKJTEQhsPg4G18g0ECbty0J-mkk85SxBsIs5mB2YVcqjWH7vQxSQvn7e1z0YUrV1VUffVXUT9Cvym5opSJxQuYVJaxr2pCZcVoTVr-Ax1TLtpN6f_BnLOmqQRh8gid5LwkhHDVikN0VCsilWDsGNmH9WqMpiQDQzDYRI9DyXiVxuc45pBxiNi4qQDe7sOdCf2UAM-dBL0p4HEZcQrPLwW_QSwpuKk3Cft17qboShjjL_SzM32Gs308Rf_ubv_ePFRPf-4fb66fKstkUyopHRjHLBFMdIR7X1PrqehsS0GJFkDWUBPlpOKNbazzioLpvCW1baUXDTtFlzvd-fjXCXLRQ8gO-t5EGKesqWokV4y3fEYvvqDLcUpxvk7XlDaUcboV5DvKpTHnBJ1epTCYtNaU6I0H-sMDvfFA7zyYx8734pMdwH8OfTx9BhY7wA7L70m-A_F_lVY</recordid><startdate>201810</startdate><enddate>201810</enddate><creator>Lee, Heesun</creator><creator>Lee, Sang Eun</creator><creator>Park, Chan Soon</creator><creator>Park, Jin Joo</creator><creator>Lee, Ga Yeon</creator><creator>Kim, Min-Seok</creator><creator>Choi, Jin-Oh</creator><creator>Cho, Hyun-jai</creator><creator>Lee, Hae-Young</creator><creator>Choi, Dong-Ju</creator><creator>Jeon, Eun-Seok</creator><creator>Kim, Jae-Joong</creator><creator>Oh, Byung-Hee</creator><general>BMJ Publishing Group LTD</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88I</scope><scope>8AF</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>201810</creationdate><title>Hyponatraemia and its prognosis in acute heart failure is related to right ventricular dysfunction</title><author>Lee, Heesun ; Lee, Sang Eun ; Park, Chan Soon ; Park, Jin Joo ; Lee, Ga Yeon ; Kim, Min-Seok ; Choi, Jin-Oh ; Cho, Hyun-jai ; Lee, Hae-Young ; Choi, Dong-Ju ; Jeon, Eun-Seok ; Kim, Jae-Joong ; Oh, Byung-Hee</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b375t-77ceac3b0636f04dd21bd16fb81e968ee72e209c7945b5bcd91eafdb02b87d653</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Cardiology</topic><topic>Heart failure</topic><topic>Medical diagnosis</topic><topic>Medical prognosis</topic><topic>Mortality</topic><topic>Pulmonary arteries</topic><topic>Pulmonary hypertension</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lee, Heesun</creatorcontrib><creatorcontrib>Lee, Sang Eun</creatorcontrib><creatorcontrib>Park, Chan Soon</creatorcontrib><creatorcontrib>Park, Jin Joo</creatorcontrib><creatorcontrib>Lee, Ga Yeon</creatorcontrib><creatorcontrib>Kim, Min-Seok</creatorcontrib><creatorcontrib>Choi, Jin-Oh</creatorcontrib><creatorcontrib>Cho, Hyun-jai</creatorcontrib><creatorcontrib>Lee, Hae-Young</creatorcontrib><creatorcontrib>Choi, Dong-Ju</creatorcontrib><creatorcontrib>Jeon, Eun-Seok</creatorcontrib><creatorcontrib>Kim, Jae-Joong</creatorcontrib><creatorcontrib>Oh, Byung-Hee</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Science Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Heart (British Cardiac Society)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lee, Heesun</au><au>Lee, Sang Eun</au><au>Park, Chan Soon</au><au>Park, Jin Joo</au><au>Lee, Ga Yeon</au><au>Kim, Min-Seok</au><au>Choi, Jin-Oh</au><au>Cho, Hyun-jai</au><au>Lee, Hae-Young</au><au>Choi, Dong-Ju</au><au>Jeon, Eun-Seok</au><au>Kim, Jae-Joong</au><au>Oh, Byung-Hee</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Hyponatraemia and its prognosis in acute heart failure is related to right ventricular dysfunction</atitle><jtitle>Heart (British Cardiac Society)</jtitle><addtitle>Heart</addtitle><date>2018-10</date><risdate>2018</risdate><volume>104</volume><issue>20</issue><spage>1670</spage><epage>1677</epage><pages>1670-1677</pages><issn>1355-6037</issn><eissn>1468-201X</eissn><abstract><![CDATA[ObjectivesHyponatraemia is a well-known predictor of clinical outcomes in heart failure (HF). However, the mechanism remains poorly understood. Previous reports suggest that hyponatraemia is related to right HF. We sought to evaluate the association between right ventricular (RV) dysfunction and hyponatraemia, and the impact of this relationship on the prognosis of patients with acute heart failure (AHF).MethodsThis is a nested case–control study of the Korean Acute Heart Failure registry. Among 2935 AHF patients enrolled prospectively and consecutively at four tertiary hospitals in Korea from 2011 to 2014, 116 patients with severe persistent hyponatraemia, defined as serum sodium level <130 mmol/L at admission and <135 mmol/L before discharge, were matched with 232 controls, based on propensity scores for hyponatraemia. RV function was assessed with fractional area change (FAC) by echocardiography.ResultsRV dysfunction (FAC <35%) was more prevalent in patients with severe persistent hyponatraemia than in those without (81.0% vs 33.6%, p<0.001). Hyponatraemia was strongly associated with RV dysfunction (adjusted OR 8.00, 95% CI 4.50 to 14.22, p<0.001), but not with left ventricular dysfunction (adjusted OR 1.21, 95% CI 0.74 to 1.50, p=0.308). RV dysfunction was an independent predictor of all-cause mortality, after adjustment for hyponatraemia (adjusted HR 2.20, 95% CI 1.53 to 3.15, p<0.001), while hyponatraemia was not (adjusted HR 1.33, 95% CI 0.94 to 1.87, p=0.108).ConclusionsIn patients with AHF, hyponatraemia was more common with RV dysfunction. RV dysfunction, rather than hyponatraemia, was more significantly related with patients’ prognosis. Thus, the utility of RV dysfunction instead of hyponatraemia per se should be considered in HF risk models.Trial registration numberKorean Acute Heart Failure registry NCT01389843; Results.]]></abstract><cop>England</cop><pub>BMJ Publishing Group LTD</pub><pmid>29079633</pmid><doi>10.1136/heartjnl-2017-312084</doi><tpages>8</tpages></addata></record> |
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| subjects | Cardiology Heart failure Medical diagnosis Medical prognosis Mortality Pulmonary arteries Pulmonary hypertension |
| title | Hyponatraemia and its prognosis in acute heart failure is related to right ventricular dysfunction |
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