Author + information
- Tasnim F. Imrana,b,
- Katherine E. Kurganskya,b,
- Yash Patela,b,
- Ariela Orkabya,b,
- Robert McLeana,b,
- Kelly Choa,b,
- David R. Gagnona,b,
- Yuk-Lam Hoa,b,
- J. Michael Gazianoa,b,
- Luc Djoussea,b and
- Jacob Josepha,b
Background: The pathophysiology of heart failure with preserved ejection fraction (HFpEF) is not well elucidated. Whether abnormalities of serum sodium, a surrogate marker of neurohormonal activation of the vasopressin system, affects outcomes in HFpEF has not been well examined.
Methods: We applied a validated algorithm to the national Veterans Affairs patient database (time period 2002-2012) to identify HFpEF subjects using the following criteria: all recorded ejection fractions > 50% and symptoms, signs and treatment for heart failure. We examined the association of serum sodium at time of diagnosis with all-cause mortality using a multivariable Cox proportional hazards model.
Results: In our cohort of 29,022 HFpEF patients (mean age 71 years, 96% men), 17,269 deaths occurred over a median follow-up of 3.6 years (IQR: 1.7-6.4). After adjusting for age, sex, race, body mass index, coronary artery disease, hypertension, hyperlipidemia, atrial fibrillation, chronic obstructive pulmonary disease, diabetes mellitus, anemia, renal function, heart rate and ejection fraction, a baseline sodium of < 135 mEq/L was significantly associated with mortality (HR 1.30; 95% CI 1.23-1.38, p < 0.0001), with a lesser association observed with sodium values of 135-138, 141-144, and > 144 mEq/L as compared to sodium of 138-141 mEq/L (reference group) (Figure 1).
Conclusions: Our study suggests that low serum sodium at diagnosis is associated with increased long-term mortality in patients with HFpEF.
Poster Hall, Hall C
Saturday, March 18, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Emerging Developments in HFpEF and Arryhthmias
Abstract Category: 13. Heart Failure and Cardiomyopathies: Clinical
Presentation Number: 1250-277
- 2017 American College of Cardiology Foundation