Association Between Serum Sodium Level and Tricuspid Annular Plane Systolic Excursion and Estimated Gkomerular Filtration Rate in Patients with Decompensated Heart Failure / 医学研究杂志

ABSTRACT

Objective To investigate the association between serum sodium level and tricuspid annular plane systolic excursion (TAPSE) and estimated glomerular filtration rate (eGFR) in patients with decompensated heart failure.Methods Totally 116 in-patients with decompensated heart failure who had left ventricular ejection fraction (LVEF) ≤ 45％ confirmed by echocardiogram and belonged to Ⅲ-Ⅳ degree of NYHA were enrolled.We collected height,weight,systolic/diastolic blood pressure and other general information on the first day of hospitalization.The dates of serum electrolyte,urea,creatinine and N-terminal pro-brain natriuretic peptide (NT-proBNP) level were detected in the second day of hospitalization on an empty stomach.Then eGFR were obtained by the modified MDRD equation.Tricuspid annular plane systolic excursion (TAPSE),left ventricular end diameter(LVED),right ventricular end diameter(RVED),pulmonary arterial systolic pressure(PASP) and left ventricular ejection fraction(LVEF) all were measured by echocardiography within 48 hours of hospitalization.All the patients were divided into two groups,the hyponatremia group and non-hyponatremia group,according to the serum sodium level (serum sodium ≤ 135mmol/L was defined as hyponatremia,n =52;serum sodium ＞135mmol/L was defined as non-hyponatremia,n =64).The NT-proBNP,LVEF,TAPSE and eGFR were compared between the two groups.Besides,for the hyponatremia group,the relevance between serum sodium level and TAPSE,eGFR were respectively analyzed.And we also analyzed the relevance between TAPSE and eGFR.Results ①The level of NT-proBNP in hyponatremia group was higher than non-hyponatremia group with statistical significance (P =0.032),while TAPSE and eGFR were lower than non-hyponatremia group with statistical significance(P =0.015,P =0.004).②Logistic regression analysis results showed that serum sodium level was positively correlated with the decrease of both TAPSE and eGFR (r =0.785,r =0.702).Meanwhile the decrease of TAPSE was also positively correlated with the decrease of eGFR(r =0.630).Conclusion Hyponatremia was positively correlated with the decrease of both TAPSE and eGFR in patients with decompensated heart failure.And hyponatremia maybe was considered as an easy and practical predictor for identifying those patients who would experience worsening renal function in early state.