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Title: | Self-Reported Sodium Intake and Sodium Vulnerability in Heart Failure With Preserved Ejection Fraction | Authors: | MARTENS, Pieter MULLENS, Wilfried Fang, James C. Tang, W. H. Wilson |
Issue Date: | 2024 | Publisher: | ELSEVIER SCIENCE INC | Source: | Mayo Clinic Proceedings, 99 (8) , p. 1271 -1283 | Abstract: | Objective: To determine the pathophysiologic and prognostic meaning of patient self-reported sodium intake in heart failure (HF) with preserved ejection fraction (HFpEF). Methods: This cohort analysis used data from the Treatment of Preserved Cardiac Function Heart Failure With an Aldosterone Antagonist (TOPCAT) trial of patients enrolled in the Americas. Tertiles of baseline self-reported sodium intake were used to assess the relationship between self-reported sodium intake and clinical presentation/outcome and interactions with treatment effect of spironolactone. Results: Self-reported sodium intake of 1748 patients with HFpEF included in TOPCAT were divided according to tertiles of sodium intake (47% low, 35% moderate, and 18% high sodium intake). After covariate adjustment, lower self-reported sodium intake was associated with higher risk of HF hospital admission (P1/4.009). P 1 / 4 .009). Patients with lower sodium intake had higher E-wave velocity, left ventricular end diastolic volume, and estimated plasma volume (P<.001). P< .001). Lower sodium intake was associated with a larger treatment effect of spironolactone on HF hospitalizations (hazard ratio, 0.69; 95% CI, 0.53 to 0.91) vs the highest tertile (hazard ratio, 1.37; 95% CI, 0.79 to 2.38; interaction P 1 / 4 .030). In addition, linear mixed models indicated larger reductions in blood pressure, dyspnea, and edema (all interaction P< .001) in patients with lower sodium intake receiving spironolactone. Conclusion: Low self-reported sodium level in HFpEF is associated with higher risk of HF hospital admissions and may indicate a sodium-vulnerable state; patients should not be falsely reassured that they are in a lower risk category despite greater adherence to medical recommendations. | Notes: | Tang, WHW (corresponding author), Cleveland Clin, Heart Vasc & Thorac Inst, Dept Cardiovasc Med, 9500 Euclid Ave,Desk J3-4, Cleveland, OH 44195 USA. tangw@ccf.org |
Document URI: | http://hdl.handle.net/1942/43706 | ISSN: | 0025-6196 | e-ISSN: | 1942-5546 | DOI: | 10.1016/j.mayocp.2024.03.005 | ISI #: | 001288130700001 | Category: | A1 | Type: | Journal Contribution |
Appears in Collections: | Research publications |
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