Relationship Between Admission Serum Sodium Concentration And Plasma Concentration Of Neuroendocrine Hormone In Patients With Congestive Heart Failure

Objective:To investigate the effects of serum sodium on plasma concentration of neuroendocrine hormone in patients with systolic heart failure, to observe the difference of serum sodium level,LVEDD and LVEDD in difference disease .Methods:68 patients with systolic heart failure were divided into two groups according to their serum sodium(Na) levels: normal serum sodium group(n=36)and hyponatremia group(n=32).The levels of plasma rennin(PRA),angiotensin(ATⅡ),aldosterone(ALD) and brain natriuretic peptide (BNP) in both groups were determined and compared. left atrial dimension(LAD),left ventricular end diastolic diameter(LVEDD)were looked as the index of heart structural change , left ventricular ejection fraction(LVEF),shortening fraction(FS)were regard as the index of heart function change ,to compare above-mentioned indexes between two group; to analyze correlation between serum sodium and above-mentioned indexes; Bivariate correlation analysis was applied to show the correlation of serum sodium level with above indexes. According to the cause of a disease , the patients were divided into coronary artery disease/coronary heart disease group(CAD/CHD, n=31),dilated cardiomyopathy group(DCM, n=20),high blood pressure group(HBP, n=17) ,to compare Na,PRA,ATⅡ,ALD,BNP,LVEDD,LVEF among three groups .68 patients with CHF were grouped asⅢclass,Ⅳclass according to NYHA grading method , to analyze the difference of Na,PRA,ATⅡ,ALD,BNP,LVEDD,LVEF level between two groups.Results :①The levels of plasma PRA,ATⅡ,ALD and BNP were significantly elevated in hyponatremia patients as compared with norm serum sodium group patients PRA(2.31±0.74ng/ml vs 1.72±0.44 ng/mlp<0.01),AngⅡ(185.19±30.44 pg/ml vs 142.71±25.67 pg/ml p<0.01),ALD(234.91±34.64pg/ml vs 187.58±43.64pg/ml p<0.01) and BNP(527.04±110.06 pg/ml vs 403.92±69.31 pg/ml p<0.01)②correlation analysis showed that Serum sodium was negatively correlated with the levels of plasma ALD,PRA,Ang,BNP and LVDD(r=-0.396, P<0.01; r=-0.510,P<0.01; r=-0.310,P=0.010; r=-0.545, P <0.01;r=-0.352, P=0.003);③Results showed that serum sodium was not correlated with the cause of systolic heart failure, Sodium level, plasma PRA, AngⅡ, ALD, BNP, LVEDD, LVEF in the three groups no significant difference(P>0.05);④Comparing with NYHAⅢgroup,The levels of plasma PRA,ATⅡ,ALD and BNP were significantly elevated in NYHAⅣgroup (P<0.05).Conclusion1. There is relation of hyponatremia to the changes of plasma PRA,AngⅡ,ALD and BNP in chronic heart failure. Hypenatremia may accelerate the excretion of plasma PRA,AngⅡ,ALD and BNP in chronic heart failure.2. Serum sodium was negatively correlated with the levels of plasma ALD,PRA,Ang,BNP and LVDD3. Neuroendocrine activation in patients of congestive heart failure with hyponatremia is higher than that of normal serum sodium group,heart sructural change is more serious.