Abstract 13808: Sympathetic Overactivation but Not Hyponatremia as Independent Predictor of Cardiovascular Events and Mortality in Patients With Chronic Heart Failure
Introduction: Previous studies have shown that hyponatremia could predict poor outcome in patients with heart failure (HF). However, it remains unknown whether hyponatremia is associated with increased poor outcomes independent of sympathetic overactivation.
Methods: We determined resting muscle sympathetic nerve activity (MSNA) and potential prognostic variables including sodium level in 121 patients with HF (63 ± 14 years, ejection fraction (EF) < 0.45). Outcomes assessed in these patients after a mean follow up of 1144 ± 704 days. The variables were analyzed using univariate, multivariate analysis and Kaplan Meier analysis.
Results: Twenty patients (21%) had hyponatremia (<136 mEq/L). MSNA values were significantly higher in hyponatremia group than in normonatremia group (burst incidence, 78 ± 20 vs. 61 ± 19 bursts/100 beats, p < 0.001). The univariate analysis showed that MSNA, specific activity scale, BNP level, estimated glomerular filtration rate, ejection fraction, sodium level and plasma renin activity were significant predictors of cardiovascular events. The multivariate analysis showed that MSNA, specific activity scale, plasma renin activity and BNP level sodium level were independent predictors of cardiac events, but sodium level was not among these patients. On the basis of median levels of MSNA and sodium level, cardiovascular events was significantly higher in patients with higher MSNA and lower sodium level, but not in those with lower MSNA and lower sodium level.
Conclusions: Hyponatremia is not independently associated with cardiovascular events in patients with chronic HF under analysis including sympathetic index.
Author Disclosures: T. Akabane: None. S. Joho: None. R. Ushijima: None. H. Inoue: None.
- © 2014 by American Heart Association, Inc.