Hyponatremia Associated with Congestive Heart Failure: Involvement of Vasopressin and Efficacy of Vasopressin Receptor Antagonists
Hyponatremia is frequently found in patients with congestive heart failure. A reduction in effective circulatory blood volume in a volume-expanded patient with decreased cardiac output is linked to a baroreceptor-mediated non-osmotic release of arginine vasopressin (AVP). The increased production of...
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| Veröffentlicht in: | Journal of clinical medicine 2023-02, Vol.12 (4), p.1482 |
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| description | Hyponatremia is frequently found in patients with congestive heart failure. A reduction in effective circulatory blood volume in a volume-expanded patient with decreased cardiac output is linked to a baroreceptor-mediated non-osmotic release of arginine vasopressin (AVP). The increased production of AVP and salt and water retention in the proximal and distal tubules of the kidney by humoral, hemodynamic, and neural mechanisms increase circulatory blood volume and contribute to hyponatremia. Recent studies have indicated that hyponatremia predicts the short-term and long-term prognosis of heart failure by increasing cardiac death and rehospitalization. In addition, the early development of hyponatremia in acute myocardial infarction also predicts the long-term prognosis of worsening heart failure. AVP V2 receptor antagonism may relieve water retention, but it is unknown whether the V2 receptor inhibitor, tolvaptan, improves the long-term prognosis of congestive heart failure. The newly identified natriuretic factor in renal salt wasting has the potential of improving clinical outcomes when combined with a distal diuretic. |
| doi_str_mv | 10.3390/jcm12041482 |
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A reduction in effective circulatory blood volume in a volume-expanded patient with decreased cardiac output is linked to a baroreceptor-mediated non-osmotic release of arginine vasopressin (AVP). The increased production of AVP and salt and water retention in the proximal and distal tubules of the kidney by humoral, hemodynamic, and neural mechanisms increase circulatory blood volume and contribute to hyponatremia. Recent studies have indicated that hyponatremia predicts the short-term and long-term prognosis of heart failure by increasing cardiac death and rehospitalization. In addition, the early development of hyponatremia in acute myocardial infarction also predicts the long-term prognosis of worsening heart failure. AVP V2 receptor antagonism may relieve water retention, but it is unknown whether the V2 receptor inhibitor, tolvaptan, improves the long-term prognosis of congestive heart failure. The newly identified natriuretic factor in renal salt wasting has the potential of improving clinical outcomes when combined with a distal diuretic.</description><identifier>ISSN: 2077-0383</identifier><identifier>EISSN: 2077-0383</identifier><identifier>DOI: 10.3390/jcm12041482</identifier><identifier>PMID: 36836016</identifier><language>eng</language><publisher>Switzerland: MDPI AG</publisher><subject>Blood ; Clinical medicine ; Complications and side effects ; Congestive heart failure ; Development and progression ; Drug therapy ; Edema ; Health aspects ; Heart attacks ; Heart failure ; Hemodynamics ; Hyponatremia ; Kinases ; Mortality ; Nervous system ; Opinion ; Plasma ; Proteins ; Risk factors ; Urine ; Vasopressin</subject><ispartof>Journal of clinical medicine, 2023-02, Vol.12 (4), p.1482</ispartof><rights>COPYRIGHT 2023 MDPI AG</rights><rights>2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). 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A reduction in effective circulatory blood volume in a volume-expanded patient with decreased cardiac output is linked to a baroreceptor-mediated non-osmotic release of arginine vasopressin (AVP). The increased production of AVP and salt and water retention in the proximal and distal tubules of the kidney by humoral, hemodynamic, and neural mechanisms increase circulatory blood volume and contribute to hyponatremia. Recent studies have indicated that hyponatremia predicts the short-term and long-term prognosis of heart failure by increasing cardiac death and rehospitalization. In addition, the early development of hyponatremia in acute myocardial infarction also predicts the long-term prognosis of worsening heart failure. AVP V2 receptor antagonism may relieve water retention, but it is unknown whether the V2 receptor inhibitor, tolvaptan, improves the long-term prognosis of congestive heart failure. The newly identified natriuretic factor in renal salt wasting has the potential of improving clinical outcomes when combined with a distal diuretic.</description><subject>Blood</subject><subject>Clinical medicine</subject><subject>Complications and side effects</subject><subject>Congestive heart failure</subject><subject>Development and progression</subject><subject>Drug therapy</subject><subject>Edema</subject><subject>Health aspects</subject><subject>Heart attacks</subject><subject>Heart failure</subject><subject>Hemodynamics</subject><subject>Hyponatremia</subject><subject>Kinases</subject><subject>Mortality</subject><subject>Nervous system</subject><subject>Opinion</subject><subject>Plasma</subject><subject>Proteins</subject><subject>Risk factors</subject><subject>Urine</subject><subject>Vasopressin</subject><issn>2077-0383</issn><issn>2077-0383</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><recordid>eNptks9rFDEUxwdRbKk9eZeAF0G25tckMx6EZWndQkEQ9RpeM2-2WWaSMcms7NW_3JTWui0mh4R8P--bvJdXVa8ZPROipR-2dmScSiYb_qw65lTrBRWNeH6wP6pOU9rSMppGcqZfVkdCNUJRpo6r3-v9FDzkiKMDskwpWAcZO_LL5RuyCn6DKbsdkjVCzOQC3DBH_Egu_S4MOxzRZxJ68gNSmCKm5DwB35HzvncW7P6p9hUtTjlEsvQZNsG7lNOr6kUPQ8LT-_Wk-n5x_m21Xlx9-Xy5Wl4trNQqL7SsoRaUU3Xd1apVFiVjoDohoWeq7Zi0rKggesk6tDUTDEEj0I61qrNKnFSf7nyn-XrEzpanRxjMFN0IcW8COPNY8e7GbMLOtK3SdcOLwbt7gxh-zqUuZnTJ4jCAxzAnw3VTasxrqQv69gm6DXP0Jb1C6bamjPP6H7WBAY3zfSj32ltTs9Q1FaLmQhbq7D9UmV35Mxs89q6cPwp4fxdgY0gpYv-QI6PmtmvMQdcU-s1hWR7Yvz0i_gBhkL3f</recordid><startdate>20230213</startdate><enddate>20230213</enddate><creator>Ishikawa, San-E</creator><creator>Funayama, Hiroshi</creator><general>MDPI AG</general><general>MDPI</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0001-6961-2361</orcidid></search><sort><creationdate>20230213</creationdate><title>Hyponatremia Associated with Congestive Heart Failure: Involvement of Vasopressin and Efficacy of Vasopressin Receptor Antagonists</title><author>Ishikawa, San-E ; Funayama, Hiroshi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c476t-745a530206bd5696ce411a6d34af169d14c1020a3f41dec5131ea7ea0d196dc63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Blood</topic><topic>Clinical medicine</topic><topic>Complications and side effects</topic><topic>Congestive heart failure</topic><topic>Development and progression</topic><topic>Drug therapy</topic><topic>Edema</topic><topic>Health aspects</topic><topic>Heart attacks</topic><topic>Heart failure</topic><topic>Hemodynamics</topic><topic>Hyponatremia</topic><topic>Kinases</topic><topic>Mortality</topic><topic>Nervous system</topic><topic>Opinion</topic><topic>Plasma</topic><topic>Proteins</topic><topic>Risk factors</topic><topic>Urine</topic><topic>Vasopressin</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ishikawa, San-E</creatorcontrib><creatorcontrib>Funayama, Hiroshi</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>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>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 Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Publicly Available Content 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>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of clinical medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ishikawa, San-E</au><au>Funayama, Hiroshi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Hyponatremia Associated with Congestive Heart Failure: Involvement of Vasopressin and Efficacy of Vasopressin Receptor Antagonists</atitle><jtitle>Journal of clinical medicine</jtitle><addtitle>J Clin Med</addtitle><date>2023-02-13</date><risdate>2023</risdate><volume>12</volume><issue>4</issue><spage>1482</spage><pages>1482-</pages><issn>2077-0383</issn><eissn>2077-0383</eissn><abstract>Hyponatremia is frequently found in patients with congestive heart failure. A reduction in effective circulatory blood volume in a volume-expanded patient with decreased cardiac output is linked to a baroreceptor-mediated non-osmotic release of arginine vasopressin (AVP). The increased production of AVP and salt and water retention in the proximal and distal tubules of the kidney by humoral, hemodynamic, and neural mechanisms increase circulatory blood volume and contribute to hyponatremia. Recent studies have indicated that hyponatremia predicts the short-term and long-term prognosis of heart failure by increasing cardiac death and rehospitalization. In addition, the early development of hyponatremia in acute myocardial infarction also predicts the long-term prognosis of worsening heart failure. AVP V2 receptor antagonism may relieve water retention, but it is unknown whether the V2 receptor inhibitor, tolvaptan, improves the long-term prognosis of congestive heart failure. 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| subjects | Blood Clinical medicine Complications and side effects Congestive heart failure Development and progression Drug therapy Edema Health aspects Heart attacks Heart failure Hemodynamics Hyponatremia Kinases Mortality Nervous system Opinion Plasma Proteins Risk factors Urine Vasopressin |
| title | Hyponatremia Associated with Congestive Heart Failure: Involvement of Vasopressin and Efficacy of Vasopressin Receptor Antagonists |
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