The Relationships Between Hyponatremia And The Cardiac Function And Prognostic Status Of The Patients With Chronic Heart Failure

ObjectivesThe aims of this study were to investigate the relationships between hyponatremia and the cardiac function and prognostic status of the patients with chronic heart failure(CHF).MethodsEight hundred and six subjects were collected from the patients with CHF who were hospitalized in the second Xiangya hospital of central south university from July 2003 to August 2004.The patients with CHF were divided into 2 groups according to serum sodium levels:normal serum sodium group(Na≥135mmol/L)and lower serum sodium group(Na＜135 mmol/L).The methods of computerized sorting accompanized with a excerpting medical records were used to collect the clinical data.Demographic data and general clinical data including underlying cardiac diseases,concomitant diseases,clinical chemistry, echocardiogram results and residential treatment regimens were all recorded.The correlations of serum sodium levels with NYHA cardiac function class as well as prognostic status in patients with CHF were analyzed by multi-factor logistic statistical method.Results1.One hundred and two cases were concomitant with hyponatremia, accounting for 12.66%of study population.2 The proportion of hypertension and cardiomyopathy in CHF with hyponatremia group was significantly higher than that in CHF with normal serum sodium group(p＜005),While there were no statistical differences between two groups in general information(including age, gender,smoking,drinking,BMI,family history of cardiovascular disease) and the history of coronary heart disease,valvular disease and diabetes mellitus(P＞0.05).3.Serum chlorine was reduced significantly in hyponatremia group(P＜0.05)and the white blood cell count,the levels of serum urea nitrogen and creatinine increased significantly in the hyponatremia group(P＜0.05).The differences of levels of the serum potassium,uric acid and fasting blood glucose(FBS),hemoglobin(Hb)and platelet(PLT) count were not statistically significant between two groups(P＞0.05).4.Ultrasonic Cardiography revealed the left atrial diameter(LAD), the left ventricular end-diastolic diameter(LVDD)and the left ventricular ejection fraction(LVEF)differs in two groups(P＜0.05).LAD,LVDD increased remarkably,but LVEF decreased significantly in the patients of CHF concomitant with hyponatremia.The level of serum natrium was positively related to the LAD and LVEFand negatively related to the LVDD,respectively. 5.There was a significant difference in NYHA cardiac function class between two groups(P＜0.05).The correlation of serum sodium levels with the cardiac function class in CHF patients were analyzed by multi-factor logistic statistical method,the serum sodium levels may be the key index in cardiac function class(P＜0.05).6.The prognosis of the lower serum sodium group was worse than the other group(P＜0.05).The relationships between serum sodium levels and the cardiac function rating in CHF patients were analyzed by multi-factor logistic statistical method,the serum sodium levels may be the key index in the prognosis of CHF(P＜0.05).7.The correlations among serum sodium levels,the NYHA cardiac function class and prognostic value were analyzed,showing that group and NYHA cardiac function class were important factors of the clinical prognosis of patients(P＜0.01).Considering cardiac function class and prognostic status,the goodness-of-fit test and correlating test of them were good.It is concluded that the prognosis aggravates as the NYHA cardiac function class elevates.Conclusions1.Serum sodium levels may be the key index in cardiac function of CHF patients.The lower serum sodium levels were,the worse cardiac function were.2.Serum sodium levels and cardiac function were important factors of the clinical prognosis of patients.The lower serum sodium levels and the worse cardiac function were,the worse prognosis were.