Correlation Between Increased Urinary Sodium Excretion and Decreased Left Ventricular Diastolic Function in Patients with Type 2 Diabetes Mellitus
Background Increased salt intake may induce hypertension, lead to cardiac hypertrophy, and exacerbate heart failure. When elderly patients develop heart failure, diastolic dysfunction is often observed, although the ejection fraction has decreased. Diabetes mellitus (DM) is an established risk facto...
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| Veröffentlicht in: | Clinical cardiology (Mahwah, N.J.) N.J.), 2009-10, Vol.32 (10), p.569-574 |
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| creator | Kagiyama, Shuntaro Koga, Tokushi Kaseda, Shigeru Ishihara, Shiro Kawazoe, Nobuyuki Sadoshima, Seizo Matsumura, Kiyoshi Takata, Yutaka Tsuchihashi, Takuya Iida, Mitsuo |
| description | Background
Increased salt intake may induce hypertension, lead to cardiac hypertrophy, and exacerbate heart failure. When elderly patients develop heart failure, diastolic dysfunction is often observed, although the ejection fraction has decreased. Diabetes mellitus (DM) is an established risk factor for heart failure. However, little is known about the relationship between cardiac function and urinary sodium excretion (U‐Na) in patients with DM.
Methods
We measured 24‐hour U‐Na; cardiac function was evaluated directly during coronary catheterization in type 2 DM (n = 46) or non‐DM (n = 55) patients with preserved cardiac systolic function (ejection fraction ≥ 60%). Cardiac diastolic and systolic function was evaluated as − dp/dt and + dp/dt, respectively.
Results
The average of U‐Na was 166.6 ± 61.2 mEq/24 hour (mean ± SD). In all patients, stepwise multivariate regression analysis revealed that − dp/dt had a negative correlation with serum B‐type natriuretic peptide (BNP; β = − 0.23, P = .021) and U‐Na (β = − 0.24, P = .013). On the other hand, + dp/dt negatively correlated with BNP (β = − 0.30, P < .001), but did not relate to U‐Na. In the DM‐patients, stepwise multivariate regression analysis showed that − dp/dt still had a negative correlation with U‐Na (β = − 0.33, P = .025).
Conclusion
The results indicated that increased urinary sodium excretion is associated with an impairment of cardiac diastolic function, especially in patients with DM, suggesting that a reduction of salt intake may improve cardiac diastolic function. Copyright © 2009 Wiley Periodicals, Inc. |
| doi_str_mv | 10.1002/clc.20664 |
| format | Article |
| fullrecord | <record><control><sourceid>wiley_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_6653740</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>CLC20664</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4444-dc089ab1836d1d43bfe47edf62edb236abecf4181caac5977467f048bb8eaaaf3</originalsourceid><addsrcrecordid>eNp1kbtuFDEUhi0EIkug4AWQGwqKSXxbz0yDBJMEIm0EEgmt5bGPiZHXs7JnstnX4InxXgikwI2L853vt_Uj9JqSE0oIOzXBnDAipXiCZrTlrGpqXj9FM0IlqVrWtEfoRc4_C0oaxp-jI9q2lPI5maFf3ZASBD36IeKPMK4BIr6MJoHOYPFN8lGnDf42WD8t8fl9GexQHS0-gz_YAtyIv0MckzdT0AmfeZ3HIXiDL6Zodhs-4q8lpkAZr_14i683K8Bsi_YwQsZXEIIfp_wSPXM6ZHh1uI_RzcX5dfe5Wnz5dNl9WFRGlFNZQ5pW97Th0lIreO9A1GCdZGB7xmWxGidoQ43WZt7WtZC1I6Lp-wa01o4fo_d772rql2DN9vk6qFXyy_JlNWivHk-iv1U_hjsl5ZzXghTBu73ApCHnBO5hlxK1LUaVYtSumMK--TfsL3loogBvD4DORgeXdDQ-P3CMUSHoTnS659Y-wOb_iapbdPvo3xNQqZw</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype></control><display><type>article</type><title>Correlation Between Increased Urinary Sodium Excretion and Decreased Left Ventricular Diastolic Function in Patients with Type 2 Diabetes Mellitus</title><source>MEDLINE</source><source>Free E-Journal (出版社公開部分のみ）</source><source>Wiley Online Library All Journals</source><source>PubMed Central</source><creator>Kagiyama, Shuntaro ; Koga, Tokushi ; Kaseda, Shigeru ; Ishihara, Shiro ; Kawazoe, Nobuyuki ; Sadoshima, Seizo ; Matsumura, Kiyoshi ; Takata, Yutaka ; Tsuchihashi, Takuya ; Iida, Mitsuo</creator><creatorcontrib>Kagiyama, Shuntaro ; Koga, Tokushi ; Kaseda, Shigeru ; Ishihara, Shiro ; Kawazoe, Nobuyuki ; Sadoshima, Seizo ; Matsumura, Kiyoshi ; Takata, Yutaka ; Tsuchihashi, Takuya ; Iida, Mitsuo</creatorcontrib><description>Background
Increased salt intake may induce hypertension, lead to cardiac hypertrophy, and exacerbate heart failure. When elderly patients develop heart failure, diastolic dysfunction is often observed, although the ejection fraction has decreased. Diabetes mellitus (DM) is an established risk factor for heart failure. However, little is known about the relationship between cardiac function and urinary sodium excretion (U‐Na) in patients with DM.
Methods
We measured 24‐hour U‐Na; cardiac function was evaluated directly during coronary catheterization in type 2 DM (n = 46) or non‐DM (n = 55) patients with preserved cardiac systolic function (ejection fraction ≥ 60%). Cardiac diastolic and systolic function was evaluated as − dp/dt and + dp/dt, respectively.
Results
The average of U‐Na was 166.6 ± 61.2 mEq/24 hour (mean ± SD). In all patients, stepwise multivariate regression analysis revealed that − dp/dt had a negative correlation with serum B‐type natriuretic peptide (BNP; β = − 0.23, P = .021) and U‐Na (β = − 0.24, P = .013). On the other hand, + dp/dt negatively correlated with BNP (β = − 0.30, P < .001), but did not relate to U‐Na. In the DM‐patients, stepwise multivariate regression analysis showed that − dp/dt still had a negative correlation with U‐Na (β = − 0.33, P = .025).
Conclusion
The results indicated that increased urinary sodium excretion is associated with an impairment of cardiac diastolic function, especially in patients with DM, suggesting that a reduction of salt intake may improve cardiac diastolic function. Copyright © 2009 Wiley Periodicals, Inc.</description><identifier>ISSN: 0160-9289</identifier><identifier>EISSN: 1932-8737</identifier><identifier>DOI: 10.1002/clc.20664</identifier><identifier>PMID: 19911350</identifier><identifier>CODEN: CLCADC</identifier><language>eng</language><publisher>New York: Wiley Periodicals, Inc</publisher><subject>Aged ; Biological and medical sciences ; Biomarkers - blood ; Cardiac Catheterization ; Cardiology. Vascular system ; Clinical Investigation ; Clinical Investigations ; Cross-Sectional Studies ; Diabetes Mellitus, Type 2 - complications ; Diabetes Mellitus, Type 2 - diet therapy ; Diabetes Mellitus, Type 2 - physiopathology ; Diabetes Mellitus, Type 2 - urine ; Diabetes. Impaired glucose tolerance ; Diastole ; Diet, Sodium-Restricted ; Endocrine pancreas. Apud cells (diseases) ; Endocrinopathies ; Etiopathogenesis. Screening. Investigations. Target tissue resistance ; Female ; Humans ; Male ; Medical sciences ; Middle Aged ; Natriuresis ; Natriuretic Peptide, Brain - blood ; Regression Analysis ; Risk Assessment ; Risk Factors ; Sodium - urine ; Sodium Chloride, Dietary - adverse effects ; Systole ; Ventricular Dysfunction, Left - diet therapy ; Ventricular Dysfunction, Left - etiology ; Ventricular Dysfunction, Left - physiopathology ; Ventricular Dysfunction, Left - urine ; Ventricular Function, Left ; Ventricular Pressure</subject><ispartof>Clinical cardiology (Mahwah, N.J.), 2009-10, Vol.32 (10), p.569-574</ispartof><rights>Copyright © 2009 Wiley Periodicals, Inc.</rights><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4444-dc089ab1836d1d43bfe47edf62edb236abecf4181caac5977467f048bb8eaaaf3</citedby><cites>FETCH-LOGICAL-c4444-dc089ab1836d1d43bfe47edf62edb236abecf4181caac5977467f048bb8eaaaf3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6653740/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6653740/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,727,780,784,885,1417,27924,27925,45574,45575,53791,53793</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=22144164$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19911350$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kagiyama, Shuntaro</creatorcontrib><creatorcontrib>Koga, Tokushi</creatorcontrib><creatorcontrib>Kaseda, Shigeru</creatorcontrib><creatorcontrib>Ishihara, Shiro</creatorcontrib><creatorcontrib>Kawazoe, Nobuyuki</creatorcontrib><creatorcontrib>Sadoshima, Seizo</creatorcontrib><creatorcontrib>Matsumura, Kiyoshi</creatorcontrib><creatorcontrib>Takata, Yutaka</creatorcontrib><creatorcontrib>Tsuchihashi, Takuya</creatorcontrib><creatorcontrib>Iida, Mitsuo</creatorcontrib><title>Correlation Between Increased Urinary Sodium Excretion and Decreased Left Ventricular Diastolic Function in Patients with Type 2 Diabetes Mellitus</title><title>Clinical cardiology (Mahwah, N.J.)</title><addtitle>Clin Cardiol</addtitle><description>Background
Increased salt intake may induce hypertension, lead to cardiac hypertrophy, and exacerbate heart failure. When elderly patients develop heart failure, diastolic dysfunction is often observed, although the ejection fraction has decreased. Diabetes mellitus (DM) is an established risk factor for heart failure. However, little is known about the relationship between cardiac function and urinary sodium excretion (U‐Na) in patients with DM.
Methods
We measured 24‐hour U‐Na; cardiac function was evaluated directly during coronary catheterization in type 2 DM (n = 46) or non‐DM (n = 55) patients with preserved cardiac systolic function (ejection fraction ≥ 60%). Cardiac diastolic and systolic function was evaluated as − dp/dt and + dp/dt, respectively.
Results
The average of U‐Na was 166.6 ± 61.2 mEq/24 hour (mean ± SD). In all patients, stepwise multivariate regression analysis revealed that − dp/dt had a negative correlation with serum B‐type natriuretic peptide (BNP; β = − 0.23, P = .021) and U‐Na (β = − 0.24, P = .013). On the other hand, + dp/dt negatively correlated with BNP (β = − 0.30, P < .001), but did not relate to U‐Na. In the DM‐patients, stepwise multivariate regression analysis showed that − dp/dt still had a negative correlation with U‐Na (β = − 0.33, P = .025).
Conclusion
The results indicated that increased urinary sodium excretion is associated with an impairment of cardiac diastolic function, especially in patients with DM, suggesting that a reduction of salt intake may improve cardiac diastolic function. Copyright © 2009 Wiley Periodicals, Inc.</description><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Biomarkers - blood</subject><subject>Cardiac Catheterization</subject><subject>Cardiology. Vascular system</subject><subject>Clinical Investigation</subject><subject>Clinical Investigations</subject><subject>Cross-Sectional Studies</subject><subject>Diabetes Mellitus, Type 2 - complications</subject><subject>Diabetes Mellitus, Type 2 - diet therapy</subject><subject>Diabetes Mellitus, Type 2 - physiopathology</subject><subject>Diabetes Mellitus, Type 2 - urine</subject><subject>Diabetes. Impaired glucose tolerance</subject><subject>Diastole</subject><subject>Diet, Sodium-Restricted</subject><subject>Endocrine pancreas. Apud cells (diseases)</subject><subject>Endocrinopathies</subject><subject>Etiopathogenesis. Screening. Investigations. Target tissue resistance</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Natriuresis</subject><subject>Natriuretic Peptide, Brain - blood</subject><subject>Regression Analysis</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>Sodium - urine</subject><subject>Sodium Chloride, Dietary - adverse effects</subject><subject>Systole</subject><subject>Ventricular Dysfunction, Left - diet therapy</subject><subject>Ventricular Dysfunction, Left - etiology</subject><subject>Ventricular Dysfunction, Left - physiopathology</subject><subject>Ventricular Dysfunction, Left - urine</subject><subject>Ventricular Function, Left</subject><subject>Ventricular Pressure</subject><issn>0160-9289</issn><issn>1932-8737</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kbtuFDEUhi0EIkug4AWQGwqKSXxbz0yDBJMEIm0EEgmt5bGPiZHXs7JnstnX4InxXgikwI2L853vt_Uj9JqSE0oIOzXBnDAipXiCZrTlrGpqXj9FM0IlqVrWtEfoRc4_C0oaxp-jI9q2lPI5maFf3ZASBD36IeKPMK4BIr6MJoHOYPFN8lGnDf42WD8t8fl9GexQHS0-gz_YAtyIv0MckzdT0AmfeZ3HIXiDL6Zodhs-4q8lpkAZr_14i683K8Bsi_YwQsZXEIIfp_wSPXM6ZHh1uI_RzcX5dfe5Wnz5dNl9WFRGlFNZQ5pW97Th0lIreO9A1GCdZGB7xmWxGidoQ43WZt7WtZC1I6Lp-wa01o4fo_d772rql2DN9vk6qFXyy_JlNWivHk-iv1U_hjsl5ZzXghTBu73ApCHnBO5hlxK1LUaVYtSumMK--TfsL3loogBvD4DORgeXdDQ-P3CMUSHoTnS659Y-wOb_iapbdPvo3xNQqZw</recordid><startdate>200910</startdate><enddate>200910</enddate><creator>Kagiyama, Shuntaro</creator><creator>Koga, Tokushi</creator><creator>Kaseda, Shigeru</creator><creator>Ishihara, Shiro</creator><creator>Kawazoe, Nobuyuki</creator><creator>Sadoshima, Seizo</creator><creator>Matsumura, Kiyoshi</creator><creator>Takata, Yutaka</creator><creator>Tsuchihashi, Takuya</creator><creator>Iida, Mitsuo</creator><general>Wiley Periodicals, Inc</general><general>Wiley</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>5PM</scope></search><sort><creationdate>200910</creationdate><title>Correlation Between Increased Urinary Sodium Excretion and Decreased Left Ventricular Diastolic Function in Patients with Type 2 Diabetes Mellitus</title><author>Kagiyama, Shuntaro ; Koga, Tokushi ; Kaseda, Shigeru ; Ishihara, Shiro ; Kawazoe, Nobuyuki ; Sadoshima, Seizo ; Matsumura, Kiyoshi ; Takata, Yutaka ; Tsuchihashi, Takuya ; Iida, Mitsuo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4444-dc089ab1836d1d43bfe47edf62edb236abecf4181caac5977467f048bb8eaaaf3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Biomarkers - blood</topic><topic>Cardiac Catheterization</topic><topic>Cardiology. Vascular system</topic><topic>Clinical Investigation</topic><topic>Clinical Investigations</topic><topic>Cross-Sectional Studies</topic><topic>Diabetes Mellitus, Type 2 - complications</topic><topic>Diabetes Mellitus, Type 2 - diet therapy</topic><topic>Diabetes Mellitus, Type 2 - physiopathology</topic><topic>Diabetes Mellitus, Type 2 - urine</topic><topic>Diabetes. Impaired glucose tolerance</topic><topic>Diastole</topic><topic>Diet, Sodium-Restricted</topic><topic>Endocrine pancreas. Apud cells (diseases)</topic><topic>Endocrinopathies</topic><topic>Etiopathogenesis. Screening. Investigations. Target tissue resistance</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Natriuresis</topic><topic>Natriuretic Peptide, Brain - blood</topic><topic>Regression Analysis</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>Sodium - urine</topic><topic>Sodium Chloride, Dietary - adverse effects</topic><topic>Systole</topic><topic>Ventricular Dysfunction, Left - diet therapy</topic><topic>Ventricular Dysfunction, Left - etiology</topic><topic>Ventricular Dysfunction, Left - physiopathology</topic><topic>Ventricular Dysfunction, Left - urine</topic><topic>Ventricular Function, Left</topic><topic>Ventricular Pressure</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kagiyama, Shuntaro</creatorcontrib><creatorcontrib>Koga, Tokushi</creatorcontrib><creatorcontrib>Kaseda, Shigeru</creatorcontrib><creatorcontrib>Ishihara, Shiro</creatorcontrib><creatorcontrib>Kawazoe, Nobuyuki</creatorcontrib><creatorcontrib>Sadoshima, Seizo</creatorcontrib><creatorcontrib>Matsumura, Kiyoshi</creatorcontrib><creatorcontrib>Takata, Yutaka</creatorcontrib><creatorcontrib>Tsuchihashi, Takuya</creatorcontrib><creatorcontrib>Iida, Mitsuo</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Clinical cardiology (Mahwah, N.J.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kagiyama, Shuntaro</au><au>Koga, Tokushi</au><au>Kaseda, Shigeru</au><au>Ishihara, Shiro</au><au>Kawazoe, Nobuyuki</au><au>Sadoshima, Seizo</au><au>Matsumura, Kiyoshi</au><au>Takata, Yutaka</au><au>Tsuchihashi, Takuya</au><au>Iida, Mitsuo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Correlation Between Increased Urinary Sodium Excretion and Decreased Left Ventricular Diastolic Function in Patients with Type 2 Diabetes Mellitus</atitle><jtitle>Clinical cardiology (Mahwah, N.J.)</jtitle><addtitle>Clin Cardiol</addtitle><date>2009-10</date><risdate>2009</risdate><volume>32</volume><issue>10</issue><spage>569</spage><epage>574</epage><pages>569-574</pages><issn>0160-9289</issn><eissn>1932-8737</eissn><coden>CLCADC</coden><abstract>Background
Increased salt intake may induce hypertension, lead to cardiac hypertrophy, and exacerbate heart failure. When elderly patients develop heart failure, diastolic dysfunction is often observed, although the ejection fraction has decreased. Diabetes mellitus (DM) is an established risk factor for heart failure. However, little is known about the relationship between cardiac function and urinary sodium excretion (U‐Na) in patients with DM.
Methods
We measured 24‐hour U‐Na; cardiac function was evaluated directly during coronary catheterization in type 2 DM (n = 46) or non‐DM (n = 55) patients with preserved cardiac systolic function (ejection fraction ≥ 60%). Cardiac diastolic and systolic function was evaluated as − dp/dt and + dp/dt, respectively.
Results
The average of U‐Na was 166.6 ± 61.2 mEq/24 hour (mean ± SD). In all patients, stepwise multivariate regression analysis revealed that − dp/dt had a negative correlation with serum B‐type natriuretic peptide (BNP; β = − 0.23, P = .021) and U‐Na (β = − 0.24, P = .013). On the other hand, + dp/dt negatively correlated with BNP (β = − 0.30, P < .001), but did not relate to U‐Na. In the DM‐patients, stepwise multivariate regression analysis showed that − dp/dt still had a negative correlation with U‐Na (β = − 0.33, P = .025).
Conclusion
The results indicated that increased urinary sodium excretion is associated with an impairment of cardiac diastolic function, especially in patients with DM, suggesting that a reduction of salt intake may improve cardiac diastolic function. Copyright © 2009 Wiley Periodicals, Inc.</abstract><cop>New York</cop><pub>Wiley Periodicals, Inc</pub><pmid>19911350</pmid><doi>10.1002/clc.20664</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Free E-Journal (出版社公開部分のみ）; Wiley Online Library All Journals; PubMed Central |
| subjects | Aged Biological and medical sciences Biomarkers - blood Cardiac Catheterization Cardiology. Vascular system Clinical Investigation Clinical Investigations Cross-Sectional Studies Diabetes Mellitus, Type 2 - complications Diabetes Mellitus, Type 2 - diet therapy Diabetes Mellitus, Type 2 - physiopathology Diabetes Mellitus, Type 2 - urine Diabetes. Impaired glucose tolerance Diastole Diet, Sodium-Restricted Endocrine pancreas. Apud cells (diseases) Endocrinopathies Etiopathogenesis. Screening. Investigations. Target tissue resistance Female Humans Male Medical sciences Middle Aged Natriuresis Natriuretic Peptide, Brain - blood Regression Analysis Risk Assessment Risk Factors Sodium - urine Sodium Chloride, Dietary - adverse effects Systole Ventricular Dysfunction, Left - diet therapy Ventricular Dysfunction, Left - etiology Ventricular Dysfunction, Left - physiopathology Ventricular Dysfunction, Left - urine Ventricular Function, Left Ventricular Pressure |
| title | Correlation Between Increased Urinary Sodium Excretion and Decreased Left Ventricular Diastolic Function in Patients with Type 2 Diabetes Mellitus |
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