The relevance of serum sodium level,pulmonary arterial systolic pressure and GFR in patients with acute decompensated heart failure

Xie Shiyao; Ma Longfei; Zhang Feifei

doi:10.3969/j.issn.1004-437X.2015.04.002

Abstract：Objective To investigate the change of serum sodium level and pulmonary arterial systolic pressure(PASP),and their relevance with glomerular filtration rate(GFR)in patients with acute decompensated heart failure(ADHF).Methods A total of 120 patients with ADHF were enrolled in this study.The datas of serum sodium,creatinin and NT -proBNP were detec-ted in the first day of hospitalization,then eGFR was obtained by the modified MDRD equation.The value of PASP and left ven-tricular ejection fraction(LVEF)were measured by the color doppler ultrasound equipment.All the patients were divided into hy-ponatremia group and non -hyponatremia group according to the serum sodium level(serum sodium <135 mmol/L was defined as hyponatremia,n =41;serum sodium≥135mmol/L was defined as non -hyponatremia,n =79).The levels of PASP,NT -proB-NP,eGFR and LVEF were compared between the two groups.The relevance between serum sodium and PASP,eGFR,NT -proBNP,LVEF were respectively analyzed in hyponatremia group.The relevance between PASP and eGFR,NT -proBNP, LVEF was also respectively analyzed in hyponatremia group.Results The levels of PASP and NT -proBNP in hyponatremia group were higher than non -hyponatremia group(P <0.05),while eGFR was lower(P <0.05)and LVEF was lower without statistical significance(P >0.05).Serum sodium was negatively correlated with PASP and the natural logarithm of NT -proBNP (r =-0.620,P <0.05;r =-0.494,P <0.05).Serum sodium was positively correlated with eGFR(r =0.816,P <0.05). PASP was significantly negatively correlated with eGFR(r =-0.558,P <0.05)and positively correlated with the natural log-arithm of NT -proBNP(r =0.830,P <0.05).Neither serum sodium or PASP was correlated with LVEF (P >0.05).Conclu-sion Both hyponatremia and the increase of PASP are correlated with the decrease of eGFR in patients with ADHF,and they may be useful for predicting cardiorenal syndrome.