Please use this identifier to cite or link to this item:
http://hdl.handle.net/1942/30232
Full metadata record
DC Field | Value | Language |
---|---|---|
dc.contributor.author | Hodson, Daniel Z. | - |
dc.contributor.author | Griffin, Matthew | - |
dc.contributor.author | Mahoney, Devin | - |
dc.contributor.author | Raghavendra, Parinita | - |
dc.contributor.author | Ahmad, Tariq | - |
dc.contributor.author | Turner, Jeffrey | - |
dc.contributor.author | Wilson, F. Perry | - |
dc.contributor.author | Tang, W. H. Wilson | - |
dc.contributor.author | Rao, Veena S. | - |
dc.contributor.author | Collins, Sean P. | - |
dc.contributor.author | MULLENS, Wilfried | - |
dc.contributor.author | Testani, Jeffrey M. | - |
dc.date.accessioned | 2019-12-23T11:53:31Z | - |
dc.date.available | 2019-12-23T11:53:31Z | - |
dc.date.issued | 2019 | - |
dc.identifier.citation | JACC-HEART FAILURE, 7(5), p. 383-391 | - |
dc.identifier.uri | http://hdl.handle.net/1942/30232 | - |
dc.description.abstract | OBJECTIVES This study sought to describe sodium excretion in acute decompensated heart failure (ADHF) clearly and to evaluate the prognostic ability of urinary sodium and fluid-based metrics. BACKGROUND Sodium retention drives volume overload, with fluid retention largely a passive, secondary phenomenon. However, parameters (urine output, body weight) used to monitor therapy in ADHF measure fluid rather than sodium balance. Thus, the accuracy of fluid-based metrics hinges on the contested assumption that urinary sodium content is consistent. METHODS Patients enrolled in the ROSE-AHF (Renal Optimization Strategies Evaluation-Acute Heart Failure) trial with 24-h sodium excretion available were studied (n = 316). Patients received protocol-driven high-dose loop diuretic therapy. RESULTS Sodium excretion through the first 24 h was highly variable (range 0.12 to 19.8 g; median 3.63 g, interquartile range: 1.85 to 6.02 g) and was not correlated with diuretic agent dose (r = 0.06; p = 0.27). Greater sodium excretion was associated with reduced mortality in a univariate model (hazard ratio: 0.80 per doubling of sodium excretion; 95% confidence interval: 0.66 to 0.95; p = 0.01), whereas gross urine output (p = 0.43), net fluid balance (p = 0.87), and weight change (p = 0.11) were not. Sodium excretion of less than the prescribed dietary sodium intake (2 g), even in the setting of a negative net fluid balance, portended a worse prognosis (hazard ratio: 2.02; 95% confidence interval: 1.17 to 3.46; p = 0.01). CONCLUSIONS In patients hospitalized with ADHF who were receiving high-dose loop diuretic agents, sodium concentration and excretion were highly variable. Sodium excretion was strongly associated with 6-month mortality, whereas traditional fluid-based metrics were not. Poor sodium excretion, even in the context of fluid loss, portends a worse prognosis. | - |
dc.description.sponsorship | This work was supported by National Institutes of Health (NIH) grants K23HL114868, L30HL115790, R01HL139629, R21HL143092, R01HL128973 (Dr. Testani), K23DK097201 (Dr. Wilson), and T32 training grant 5T32HL007950 (Dr. Griffin). Dr. Tang has received consultant fees from Sequana Medical and MyoKardia. Dr. Collins has been a consultant for Novartis, Vixiar, Ortho Clinical, and Medtronic; and has received research support from Ortho Clinical. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. | - |
dc.language.iso | en | - |
dc.publisher | ELSEVIER SCI LTD | - |
dc.rights | 2019 the American College of Cardiology Foundation. Published by Elsevier. All rights reserved. | - |
dc.subject.other | body weight | - |
dc.subject.other | diuretic agents | - |
dc.subject.other | heart failure | - |
dc.subject.other | sodium excretion | - |
dc.title | Natriuretic Response Is Highly Variable and Associated With 6-Month Survival Insights From the ROSE-AHF Trial | - |
dc.type | Journal Contribution | - |
dc.identifier.epage | 391 | - |
dc.identifier.issue | 5 | - |
dc.identifier.spage | 383 | - |
dc.identifier.volume | 7 | - |
local.format.pages | 9 | - |
local.bibliographicCitation.jcat | A1 | - |
dc.description.notes | [Hodson, Daniel Z.; Griffin, Matthew; Mahoney, Devin; Raghavendra, Parinita; Ahmad, Tariq; Rao, Veena S.; Testani, Jeffrey M.] Yale Univ, Sch Med, Sect Cardiovasc Med, New Haven, CT USA. [Turner, Jeffrey; Wilson, F. Perry] Yale Univ, Sch Med, Sect Nephrol, New Haven, CT USA. [Tang, W. H. Wilson] Cleveland Clin, Lerner Coll Med, Dept Cardiovasc Med, Cleveland, OH 44106 USA. [Collins, Sean P.] Vanderbilt Univ, Med Ctr, Dept Emergency Med, Nashville, TN USA. [Mullens, Wilfried] Hasselt Univ, Fac Med & Life Sci, Genk Biomed Res Inst, Dept Cardiol,Ziekenhuis Oost Limburg, Diepenbeek, Belgium. | - |
local.publisher.place | OXFORD | - |
local.type.refereed | Refereed | - |
local.type.specified | Article | - |
dc.identifier.doi | 10.1016/j.jchf.2019.01.007 | - |
dc.identifier.isi | 000466501900002 | - |
dc.identifier.eissn | 2213-1787 | - |
local.provider.type | - | |
local.uhasselt.uhpub | yes | - |
item.validation | ecoom 2020 | - |
item.accessRights | Closed Access | - |
item.fullcitation | Hodson, Daniel Z.; Griffin, Matthew; Mahoney, Devin; Raghavendra, Parinita; Ahmad, Tariq; Turner, Jeffrey; Wilson, F. Perry; Tang, W. H. Wilson; Rao, Veena S.; Collins, Sean P.; MULLENS, Wilfried & Testani, Jeffrey M. (2019) Natriuretic Response Is Highly Variable and Associated With 6-Month Survival Insights From the ROSE-AHF Trial. In: JACC-HEART FAILURE, 7(5), p. 383-391. | - |
item.fulltext | With Fulltext | - |
item.contributor | Hodson, Daniel Z. | - |
item.contributor | Griffin, Matthew | - |
item.contributor | Mahoney, Devin | - |
item.contributor | Raghavendra, Parinita | - |
item.contributor | Ahmad, Tariq | - |
item.contributor | Turner, Jeffrey | - |
item.contributor | Wilson, F. Perry | - |
item.contributor | Tang, W. H. Wilson | - |
item.contributor | Rao, Veena S. | - |
item.contributor | Collins, Sean P. | - |
item.contributor | MULLENS, Wilfried | - |
item.contributor | Testani, Jeffrey M. | - |
crisitem.journal.issn | 2213-1779 | - |
crisitem.journal.eissn | 2213-1787 | - |
Appears in Collections: | Research publications |
SCOPUSTM
Citations
10
checked on Sep 3, 2020
WEB OF SCIENCETM
Citations
57
checked on May 18, 2024
Page view(s)
28
checked on Jul 22, 2022
Download(s)
2
checked on Jul 22, 2022
Google ScholarTM
Check
Altmetric
Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.