Short and long-term prognostic value of hyponatremia in heart failure with preserved ejection fraction versus reduced ejection fraction: An analysis of the Korean Acute Heart Failure registry

Jin Joo Park, Young Jin Cho, Il Young Oh, Hyun Ah Park, Hae Young Lee, Kye Hun Kim, Byung Su Yoo, Seok Min Kang, Sang Hong Baek, Eun Seok Jeon, Jae Joong Kim, Myeong Chan Cho, Shung Chull Chae, Byung Hee Oh, Dong Ju Choi

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8 Citations (Scopus)

Abstract

Background Hyponatremia is a well-known risk factor for worse outcomes in heart failure (HF) patients. The impact of hyponatremia according to the ejection fraction (EF) is unclear. We evaluated the prognostic value of hyponatremia according to HF type. Methods and results The Korea Acute Heart Failure (KorAHF) registry consecutively enrolled 5625 patients. Hyponatremia was defined as serum sodium level < 135 mmol/L at hospital admission. HF with preserved and reduced ejection fraction were defined as an LVEF ≥ 50% and LVEF ≤ 40%, respectively. Among 5103 patients with available EF, 2088 (60%) had HFrEF, and 1284 (25%) had HFpEF. There was no difference in serum sodium level between the groups (HFrEF: 137.4 ± 4.7 mmol/L vs. HFpEF: 137.5 ± 5.0 mmol/L, P = 0.710). Hyponatremic patients had higher in-hospital mortality or urgent heart transplantation in all (11.3% vs. 4.5%, P < 0.001), in HFrEF (13.1% vs. 4.9%, P < 0.001), and in HFpEF (6.0% vs. 1.9%, P < 0.001). After adjustment for significant covariates, hyponatremia was associated with 1.5 fold increased risk for 1-year post-discharge death in the HFrEF group (HR, 1.52; 95% CI, 1.24–1.86), but not in the HFpEF group (HR, 1.16; 95% CI, 0.84–1.61). During admission, the sodium status changed in 22% of the patients and the discharge sodium status had greater prognostic value. Conclusions Hyponatremia is independent of HF type. Hyponatremia is a significant risk factor for adverse in-hospital outcomes; however its long-term prognostic value is only limited to patients with HFrEF, but not for those with HFpEF.

Original languageEnglish
Pages (from-to)239-245
Number of pages7
JournalInternational Journal of Cardiology
Volume248
DOIs
Publication statusPublished - 2017 Dec 1

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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