Abstract:
BACKGROUND:Hyponatremia (HN) is relatively common in adults with congenital heart disease and is a powerful predictor of mortality. However, the precise relationship of HN to the Fontan pathophysiology remains unknown. PURPOSE:Our study aimed to clarify the association of HN to the Fontan pathophysiology. METHODS AND RESULTS:We measured the plasma sodium (Na) level in 169 consecutive Fontan patients (78 children) and HN (≤137 mEq/L) was observed in 50 patients (30% of the total patients, 31% of the children). The HN patients showed a lower peak oxygen uptake (VO(2) ) with a greater New York Heart Association class (P < .0001). The plasma level of norepinephrine (NE), rennin activity (PRA), arginine vasopressin, central venous pressure (CVP) and medications were associated with the Na levels and the NE, PRA, and diuretic use were the independent determinants (P < .01-.0001). The plasma B-type natriuretic peptide was not correlated with the Na levels. In the children, diuretic use and the PRA independently determined the Na levels without any association to the CVP or peak VO(2) . During a median follow-up of 2.1 years, the HN in addition to the CVP and peak VO(2) independently predicted the unscheduled hospitalizations in all patients, while the HN was the only independent predictor of the hospitalizations in the adult patients (hazard ratio: 3.1, 95% confidence interval 1.2-8.0, P = .021). CONCLUSIONS:Child and adult Fontan patients exhibited a high prevalence for HN that closely reflected some neurohumoral activation and predicted adverse clinical events, especially in adult Fontan patients.
journal_name
Congenit Heart Disjournal_title
Congenital heart diseaseauthors
Ohuchi H,Negishi J,Ono S,Miyake A,Toyota N,Tamaki W,Miyazaki A,Yamada Odoi
10.1111/j.1747-0803.2011.00503.xsubject
Has Abstractpub_date
2011-07-01 00:00:00pages
304-12issue
4eissn
1747-079Xissn
1747-0803journal_volume
6pub_type
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journal_title:Congenital heart disease
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journal_title:Congenital heart disease
pub_type: 杂志文章
doi:10.1111/j.1747-0803.2006.00040.x
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