Effect of different serum sodium levels on heart function and prognosis in very elderly patients with heart failure
10.3760/cma.j.issn.0254-9026.2018.09.002
- VernacularTitle:不同血清钠离子水平对高龄心力衰竭患者心功能和预后的影响
- Author:
Yu ZHANG
1
;
Xin LI
;
Xiao LENG
;
Cunjin WU
;
Xiaokun GUO
;
Jiaohong HUANG
;
Hongmei ZHANG
;
Zhongyan WANG
;
Fang SONG
;
Le LIU
;
Huining YU
;
Jiaolei LIU
;
Qingjun LIU
;
Chao WANG
;
Lin WANG
Author Information
1. 300211,天津医科大学第二医院干部保健医疗部 天津市老年病研究所
- Keywords:
Hyponatremia;
Heart failure;
Prognosis
- From:
Chinese Journal of Geriatrics
2018;37(9):962-965
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the effect of different serum sodium levels on heart function and prognosis in very elderly patients with heart failure. Methods Totally 152 elderly patients(aged ≥ 85 years)with hyponatremia were enrolled.Based on the serum sodium level ,they were divided into mild(125 mmol/L ≤ Na+ < 135 mmol/L) ,moderate(125 mmol/L ≤ Na+ < 135 mmol/L) ,and severe hyponatremia(Na+ < 115 mmol/L)groups ,and 76 patients with normal blood sodium level(Na+ ≥ 135 mmol/L)were selected as control group. The general data ,levels of serum creatinine and N-terminal pro-brain natriuretic peptide (NTproBNP)and prognosis were compared among the above groups. Results Compared with the control group ,patients with severe hyponatremia were much older ,with more diuretics administration ,higher level of serum creatinine , lowerlevelofeGFRandleftventricularejectionfractions[(38.1±3.9)％ vs.(45.2±9.7)％ ].There were higher incidences of coronary atherosclerotic heart disease [72.4％ (n=21)vs. 56.6％ (n=43)] ,diabetes[41.4％ (n=12)vs. 23.7％ (n=18)] ,chronic renal insufficiency [22.6％ (n=8)vs. 11.8％ (n=9)] ,stroke[20.6％ (n=6)vs. 9.2％ (n=7)]in patients with severe hyponatremia compared with other groups. The severe hyponatremia group showed significantly higher levels of NTproBNP [(4823. 9 ± 588. 1 )ng/L v s. (1124. 4 ± 349. 1 )ng/L ,(1836. 2 ± 369. 3 )ng/L ,(2894. 1 ± 687. 3 )ng/L ]and higher rates of mortality [27.6％ (n=8) vs.5.3％ (n=4) ,7.6％ (n=6) ,13.6％ (n=6)]as compared to the control group ,mild and moderate hyponatremia groups. Furthermore ,length of stay in hospital were markedly longer in patients with severe hyponatremia than those with mild and moderate hyponatremia[(11.1 ± 7.1)d vs. (19.6 ± 5.7)d ,(16.1 ± 4.2)d] . Conclusions Hyponatremia is a common type of electrolyte disorder in very elderly patients with heart failure ,and severe hyponatremia may predictand increased risk of death.
