Abstract 16289: Drinking Behavior Modulation Markedly Improves Cardiac Function and Survival in Rats with Chronic Heart Failure

Abstract

Introduction: Although international guidelines recommended fluid restriction up to 1-1.5L/day for patients with chronic heart failure (CHF), few scientific evidences supports it with further detailed instructions. Our previous study revealed that CHF rats are likely to extend drinking intervals with increasing the volume. We hypothesized that this drinking style increase hemodynamic perturbation and that behavioral restoration may be a potential therapeutic target. The present study aimed to assess the outcomes of changing drinking style on the prognosis in CHF rats.

Methods: Myocardial infarction was induced by ligation the proximal left coronary artery in male rats. Survived rats were randomly assigned to drinking ad libitum (n=17) and drinking control (DC, n=19) groups. The drinking flow was monitored and modulated by an original developed feedback controlled system. The intake volume was individualized by the body weight (3.75mL/kg/30min). Cardiac function was evaluated by telemetry technique for recording artery pressure and by echocardiography in anesthesia follow with blood sampling for biochemical and neurohumoral assay.

Results: By modulating the drinking rate and interval, daily fluid consumption decreased by 37% at the first week (97±26 vs. 61±5.9 ml/kg/day, n=10, p<0.01). After 4-weeks fluid control, left ventricular ejection fraction increased (24.5 ± 6.1 vs. 30.3 ± 6.6 %, n=8; p<0.05); plasma BNP level (481 ± 64 vs. 375 ±34 pg/ml, n=8; p<0.05) and norepinephrine (815±236 vs. 512±155pg/ml, n=8; p<0.05) decreased. Hemodynamics significantly improved in DC rats evidenced by increased systolic pressure (99 ± 4.3 vs.107 ± 4.4 mmHg, n=8; p<0.01); possibly associated with heart rate decrease (361 ± 19 vs.319 ± 7bpm; p<0.01). Survival rate was improved in DC rats (6 months after MI, 77.7% vs. 41.6%; p<0.01).

Conclusion: This study provided experimental evidences for the essentials of fluid management in CHF. The results showed that simple controlling per drinking volume led to decrease daily fluid consumption, thereby improving cardiac function and survival rate in CHF rats. CHF patients may benefit from an optimal fluid prescription including the individualized per drinking volume and timing.