Skip to main content
Top
Published in: Heart Failure Reviews 2/2009

01-06-2009

Hyponatremia in heart failure

Authors: Dimitrios Farmakis, Gerasimos Filippatos, John Parissis, Dimitrios Th. Kremastinos, Mihai Gheorghiade

Published in: Heart Failure Reviews | Issue 2/2009

Login to get access

Abstract

Hyponatremia is the most common electrolyte abnormality found in hospitalized patients with heart failure. It may occur in patients who have hypovolemic, hypervolemic, or euvolemic state. It is usually not corrected by available therapies. It is a major predictor of prognosis, and correction of hyponatremia can be effectively accomplished by vasopressin antagonists. However, it still remains to be seen whether the normalization of serum sodium with vasopressin antagonists will also lead to an improved long-term prognosis.
Literature
4.
go back to reference Anderson RJ, Chung H-M, Kluge R, Schrier RW (1985) Hyponatremia: a prospective analysis of its epidemiology and the pathogenetic role of vasopressin. Ann Intern Med 102:164–168PubMed Anderson RJ, Chung H-M, Kluge R, Schrier RW (1985) Hyponatremia: a prospective analysis of its epidemiology and the pathogenetic role of vasopressin. Ann Intern Med 102:164–168PubMed
5.
go back to reference Fall PJ (2000) Hyponatremia and hypernatremia: a systematic approach to causes and their correction. Postgrad Med 107:75–82PubMed Fall PJ (2000) Hyponatremia and hypernatremia: a systematic approach to causes and their correction. Postgrad Med 107:75–82PubMed
7.
go back to reference Sica DA (2005) Hyponatremia and heart failure—pathophysiology and implications. Congest Heart Fail 11:274–277PubMedCrossRef Sica DA (2005) Hyponatremia and heart failure—pathophysiology and implications. Congest Heart Fail 11:274–277PubMedCrossRef
8.
10.
go back to reference Klein L, O’Connor CM, Leimberger JD, Gattis-Stough W, Pina IL, Felker GM et al for the OPTIME-CHF investigators (2005) Lower serum sodium is associated with increased short-term mortality in hospitalized patients with worsening heart failure: results from the OPTIME-CHF study. Circulation 111:2454–2460. doi:10.1161/01.CIR.0000165065.82609.3D Klein L, O’Connor CM, Leimberger JD, Gattis-Stough W, Pina IL, Felker GM et al for the OPTIME-CHF investigators (2005) Lower serum sodium is associated with increased short-term mortality in hospitalized patients with worsening heart failure: results from the OPTIME-CHF study. Circulation 111:2454–2460. doi:10.​1161/​01.​CIR.​0000165065.​82609.​3D
11.
go back to reference Gheorghiade M, Hellkamp AS, Pina IL et al (2005) Hemodynamic characterization and prognostic value of persistent hyponatremia in patients with severe heart failure in the ESCAPE trial. J Am Coll Cardiol 45(suppl):145A [Abstract] Gheorghiade M, Hellkamp AS, Pina IL et al (2005) Hemodynamic characterization and prognostic value of persistent hyponatremia in patients with severe heart failure in the ESCAPE trial. J Am Coll Cardiol 45(suppl):145A [Abstract]
15.
go back to reference Schrier RW, Berl T, Anderson RJ (1979) Osmotic and non-osmotic control of vasopressin release. Am J Physiol 236:F321–F332PubMed Schrier RW, Berl T, Anderson RJ (1979) Osmotic and non-osmotic control of vasopressin release. Am J Physiol 236:F321–F332PubMed
19.
go back to reference Chen MC, Chang HW, Cheng CI, Chen YH, Chai HT (2003) Risk stratification of in-hospital mortality in patients hospitalized for chronic congestive heart failure secondary to non-ischemic cardiomyopathy. Cardiology 100:136–142. doi:10.1159/000073931 PubMedCrossRef Chen MC, Chang HW, Cheng CI, Chen YH, Chai HT (2003) Risk stratification of in-hospital mortality in patients hospitalized for chronic congestive heart failure secondary to non-ischemic cardiomyopathy. Cardiology 100:136–142. doi:10.​1159/​000073931 PubMedCrossRef
20.
go back to reference Lee WH, Packer M (1986) Prognostic importance of serum sodium concentration and its modification by converting-enzyme inhibition in patients with severe chronic heart failure. Circulation 73:257–267PubMed Lee WH, Packer M (1986) Prognostic importance of serum sodium concentration and its modification by converting-enzyme inhibition in patients with severe chronic heart failure. Circulation 73:257–267PubMed
23.
go back to reference O’Connor CM, Adams KF, Gattis WA et al (2005) Predictors of mortality in patients hospitalized with worsening heart failure: insight from the ACTIV in CHF trial. J Am Coll Cardiol 45(suppl):151A [Abstract] O’Connor CM, Adams KF, Gattis WA et al (2005) Predictors of mortality in patients hospitalized with worsening heart failure: insight from the ACTIV in CHF trial. J Am Coll Cardiol 45(suppl):151A [Abstract]
24.
25.
go back to reference Krumholz HM, Chen YT, Bradford WD, Cerese J (1999) Variations in and correlates of length of stay in academic hospitals among patients with heart failure resulting from systolic dysfunction. Am J Manag Care 5:715–723PubMed Krumholz HM, Chen YT, Bradford WD, Cerese J (1999) Variations in and correlates of length of stay in academic hospitals among patients with heart failure resulting from systolic dysfunction. Am J Manag Care 5:715–723PubMed
27.
28.
go back to reference Gheorghiade M, Gattis WA, O’Connor CM, Adams KF Jr, Elkayam U, Barbagelata A et al & Acute and Chronic Therapeutic Impact of a Vasopressin Antagonist in Congestive Heart Failure (ACTIV in CHF) Investigators (2004) Effects of tolvaptan, a vasopressin antagonist, in patients hospitalized with worsening heart failure: a randomized controlled trial. JAMA 291:1963–1971. doi:10.1001/jama.291.16.1963 Gheorghiade M, Gattis WA, O’Connor CM, Adams KF Jr, Elkayam U, Barbagelata A et al & Acute and Chronic Therapeutic Impact of a Vasopressin Antagonist in Congestive Heart Failure (ACTIV in CHF) Investigators (2004) Effects of tolvaptan, a vasopressin antagonist, in patients hospitalized with worsening heart failure: a randomized controlled trial. JAMA 291:1963–1971. doi:10.​1001/​jama.​291.​16.​1963
29.
go back to reference Binanay C, Califf RM, Hasselblad V, O’Connor CM, Shah MR, Sopko G et al & ESCAPE Investigators and ESCAPE Study Coordinators (2005) Evaluation study of congestive heart failure and pulmonary artery catheterization effectiveness: the ESCAPE trial. JAMA 294:1625–1633. doi:10.1001/jama.294.13.1625 Binanay C, Califf RM, Hasselblad V, O’Connor CM, Shah MR, Sopko G et al & ESCAPE Investigators and ESCAPE Study Coordinators (2005) Evaluation study of congestive heart failure and pulmonary artery catheterization effectiveness: the ESCAPE trial. JAMA 294:1625–1633. doi:10.​1001/​jama.​294.​13.​1625
30.
go back to reference Lilly LS, Dzau VJ, Williams GH, Rydstedt L, Hollenberg NK (1984) Hyponatremia in congestive heart failure: implications for neurohormonal activation and responses to orthostasis. J Clin Endocrinol Metab 59:924–930PubMedCrossRef Lilly LS, Dzau VJ, Williams GH, Rydstedt L, Hollenberg NK (1984) Hyponatremia in congestive heart failure: implications for neurohormonal activation and responses to orthostasis. J Clin Endocrinol Metab 59:924–930PubMedCrossRef
31.
go back to reference Dzau VJ, Packer M, Lilly LS, Swartz SL, Hollenberg NK, Williams GH (1984) Prostaglandins in severe congestive heart failure: relation to activation of the renin-angiotensin system and hyponatremia. N Engl J Med 310:347–352PubMed Dzau VJ, Packer M, Lilly LS, Swartz SL, Hollenberg NK, Williams GH (1984) Prostaglandins in severe congestive heart failure: relation to activation of the renin-angiotensin system and hyponatremia. N Engl J Med 310:347–352PubMed
32.
go back to reference Brater C (2000) Diuretic therapy in congestive heart failure. Congest Heart Fail 6:197–201PubMed Brater C (2000) Diuretic therapy in congestive heart failure. Congest Heart Fail 6:197–201PubMed
33.
35.
go back to reference Ghali JK, Koren MJ, Taylor JR, Brooks-Asplund E, Fan K, Long WA et al (2006) Efficacy and safety of oral conivaptan: a V1A/V2 vasopressin receptor antagonist, assessed in a randomized, placebo-controlled trial in patients with euvolemic or hypervolemic hyponatremia. J Clin Endocrinol Metab 91:2145–2152. doi:10.1210/jc.2005-2287 PubMedCrossRef Ghali JK, Koren MJ, Taylor JR, Brooks-Asplund E, Fan K, Long WA et al (2006) Efficacy and safety of oral conivaptan: a V1A/V2 vasopressin receptor antagonist, assessed in a randomized, placebo-controlled trial in patients with euvolemic or hypervolemic hyponatremia. J Clin Endocrinol Metab 91:2145–2152. doi:10.​1210/​jc.​2005-2287 PubMedCrossRef
36.
go back to reference Schrier RW, Gross P, Gheorghiade M, Berl T, Verbalis JG, Czerwiec FS et al; SALT Investigators (2006) Tolvaptan, a selective oral vasopressin V2-receptor antagonist, for hyponatremia. N Engl J Med 355:2099–2112. doi:10.1056/NEJMoa065181 Schrier RW, Gross P, Gheorghiade M, Berl T, Verbalis JG, Czerwiec FS et al; SALT Investigators (2006) Tolvaptan, a selective oral vasopressin V2-receptor antagonist, for hyponatremia. N Engl J Med 355:2099–2112. doi:10.​1056/​NEJMoa065181
37.
go back to reference Gheorghiade M, Konstam MA, Burnett JC Jr et al (2007) Short-term clinical effects of tolvaptan, an oral vasopressin antagonist, in patients hospitalized for heart failure: the EVEREST Clinical Status Trials. JAMA 297:1332–1343. doi:10.1001/jama.297.12.1332 PubMedCrossRef Gheorghiade M, Konstam MA, Burnett JC Jr et al (2007) Short-term clinical effects of tolvaptan, an oral vasopressin antagonist, in patients hospitalized for heart failure: the EVEREST Clinical Status Trials. JAMA 297:1332–1343. doi:10.​1001/​jama.​297.​12.​1332 PubMedCrossRef
39.
go back to reference Abraham WT, Shamshirsaz AA, McFann K, Oren RM, Schrier RW (2006) Aquaretic effect of lixivaptan, an oral, non-peptide, selective V2 receptor vasopressin antagonist, in New York Heart Association functional class II and III chronic heart failure patients. J Am Coll Cardiol 47:1615–1621. doi:10.1016/j.jacc.2005.11.071 PubMedCrossRef Abraham WT, Shamshirsaz AA, McFann K, Oren RM, Schrier RW (2006) Aquaretic effect of lixivaptan, an oral, non-peptide, selective V2 receptor vasopressin antagonist, in New York Heart Association functional class II and III chronic heart failure patients. J Am Coll Cardiol 47:1615–1621. doi:10.​1016/​j.​jacc.​2005.​11.​071 PubMedCrossRef
40.
go back to reference Rossi J, Bayram M, Udelson JE et al (2007) Improvement in hyponatremia during hospitalization for worsening heart failure is associated with improved outcomes: insights from the Acute and Chronic Therapeutic Impact of a Vasopressin Antagonist in Chronic Heart Failure (ACTIV in CHF) trial. Acute Card Care 9(2):82–86. doi:10.1080/17482940701210179 PubMedCrossRef Rossi J, Bayram M, Udelson JE et al (2007) Improvement in hyponatremia during hospitalization for worsening heart failure is associated with improved outcomes: insights from the Acute and Chronic Therapeutic Impact of a Vasopressin Antagonist in Chronic Heart Failure (ACTIV in CHF) trial. Acute Card Care 9(2):82–86. doi:10.​1080/​1748294070121017​9 PubMedCrossRef
Metadata
Title
Hyponatremia in heart failure
Authors
Dimitrios Farmakis
Gerasimos Filippatos
John Parissis
Dimitrios Th. Kremastinos
Mihai Gheorghiade
Publication date
01-06-2009
Publisher
Springer US
Published in
Heart Failure Reviews / Issue 2/2009
Print ISSN: 1382-4147
Electronic ISSN: 1573-7322
DOI
https://doi.org/10.1007/s10741-008-9109-7

Other articles of this Issue 2/2009

Heart Failure Reviews 2/2009 Go to the issue