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【medical-news】低钠血症与肺动脉高压死亡率相关
A link between hyponatremia and advanced left heart failure is well established, but the association, if any, with right heart failure was unknown, the report indicates.
"This is the first study to show the powerful prognostic significance of low blood sodium in these patients," lead author Dr. Paul R. Forfia, from the University of Pennsylvania, Philadelphia, said in a statement.
The researchers' study involved a prospective assessment of 40 patients with PAH. Thirteen of the patients had hyponatremia, defined as a serum sodium level no greater than 136 mEq/L.
"Given the prevalence of right heart failure in (PAH) patients, we sought to determine whether hyponatremia is associated with more advanced right heart failure as well as worse prognosis," Dr. Forfia added.
Compared with their normonatremic counterparts, patients with hyponatremia were more symptomatic and had more peripheral edema. Moreover, during 2 years of follow-up, those with hyponatremia were approximately twice as likely to be hospitalized.
In terms of right heart failure, hyponatremic patients had higher right atrial pressure, lower stroke volume index, larger ratio of right ventricular to left ventricular area, and lower tricuspid annular plane systolic excursion compared with normonatremic patients. The mean pulmonary artery pressure in each group, however, was similar.
The 2-year survival estimate for hyponatremic subjects was 15%, much lower than the 85% noted in normonatremic patients (p < 0.001).
Hyponatremia remained a predictor of PAH outcomes after adjusting for World Health Organization class, diuretic use, right atrial pressure, and cardiac index, the report indicates.
In light of these findings, Dr. Forfia concluded that "serum sodium has important implications regarding right heart dysfunction, clinical right heart failure, and patient outcome and should not be overlooked in the clinical assessment of patients with PAH."
Am J Respir Crit Care Med 2008;177:1364-1369. original article NEW YORK (Reuters Health) Jun 13 - In patients with pulmonary arterial hypertension (PAH), hyponatremia is associated with an increased risk of right heart failure and death, according to a report in the second June issue of the American Journal of Respiratory and Critical Care Medicine.
纽约（路透社）6月13. 在肺动脉高压患者中，低钠血症同右心衰和死亡增加的危险性有关，据一份来自美国呼吸和重症医学杂志六月第二卷的报道说。
A link between hyponatremia and advanced left heart failure is well established, but the association, if any, with right heart failure was unknown, the report indicates.
文章指出，低钠血症与进展性心力衰竭之间的关系已被很好地确认，但其同右心衰的关系，如果有任何关系的话，并不知道。
"This is the first study to show the powerful prognostic significance of low blood sodium in these patients," lead author Dr. Paul R. Forfia, from the University of Pennsylvania, Philadelphia, said in a statement.
“这是显示低钠血症在这些患者强有力的预后重要性的首次研究”，来自美国宾西法尼亚州，费城的牵头作者福尔非亚，鲍尔 R博士，在评论时说。
The researchers' study involved a prospective assessment of 40 patients with PAH. Thirteen of the patients had hyponatremia, defined as a serum sodium level no greater than 136 mEq/L.
该研究涉及到对40位肺动脉高压患者进行前瞻性的评估。将低钠血症定义为血浆钠小于136 mEq/L，则其中13个患者有低钠血症。
"Given the prevalence of right heart failure in (PAH) patients, we sought to determine whether hyponatremia is associated with more advanced right heart failure as well as worse prognosis," Dr. Forfia added.
“考虑到肺动脉高压患者右心衰发生率，我们寻找确定是否低钠血症，排出了误诊，是否同更多的进展性右心衰有关。” 福尔非亚博士补充说。
Compared with their normonatremic counterparts, patients with hyponatremia were more symptomatic and had more peripheral edema. Moreover, during 2 years of follow-up, those with hyponatremia were approximately twice as likely to be hospitalized.
与正常血钠者比较，低钠血症患者有更多症状和更多患外周浮肿。并且，在随后的2年随访中，那些低钠血症患者接近2倍的住院率。
In terms of right heart failure, hyponatremic patients had higher right atrial pressure, lower stroke volume index, larger ratio of right ventricular to left ventricular area, and lower tricuspid annular plane systolic excursion compared with normonatremic patients. The mean pulmonary artery pressure in each group, however, was similar.
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作者:admin@医学,生命科学 2010-09-24 17:11
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