Hyponatremia in congestive heart failure: implications for neurohumoral activation and responses to orthostasis.

Journal Article (Journal Article)

To study the relationship between serum Na concentration and impairment of homeostatic mechanisms in advanced congestive heart failure (CHF), we evaluated the status of the sympathetic nervous system, renin-angiotensin system, and regional visceral blood flow in 26 patients with this syndrome. Compared with normal subjects, hyponatremic patients had marked stimulation of PRA (P = 0.012), norepinephrine (P less than 0.001), and epinephrine (P less than 0.001) with severe impairment of renal (P less than 0.001) and hepatic (P less than 0.003) plasma flows. In contrast, normonatremic patients, with an apparently similar degree of CHF, demonstrated less pronounced abnormalities in all of these parameters. Moreover, the responses of neurohormones and regional blood flow to orthostatic stress were greatly attenuated in the hyponatremic patients, whereas, the normonatremic subjects had more normal responses. We conclude that serum Na concentration serves as a useful index of activation of the sympathetic nervous system, renin-angiotensin system, and impairment of regional perfusion in patients with advanced CHF.

Full Text

Duke Authors

Cited Authors

  • Lilly, LS; Dzau, VJ; Williams, GH; Rydstedt, L; Hollenberg, NK

Published Date

  • November 1, 1984

Published In

Volume / Issue

  • 59 / 5

Start / End Page

  • 924 - 930

PubMed ID

  • 6384261

International Standard Serial Number (ISSN)

  • 0021-972X

Digital Object Identifier (DOI)

  • 10.1210/jcem-59-5-924


  • eng

Conference Location

  • United States