Abnormalities of sodium handling and of cardiovascular adaptations during high salt diet in patients with mild heart failure.

摘要: BACKGROUND Sodium retention and hormonal activation are fundamental hallmarks in congestive heart failure. The present study was designed to assess the ability of patients with asymptomatic mildly symptomatic failure no signs or symptoms congestion excrete ingested sodium identify possible early abnormalities hemodynamic mechanisms related handling. METHODS AND RESULTS effects a high salt diet (250 mEq/day for 6 days) on hemodynamics, salt-regulating hormones, renal excretory response were investigated balanced 12 untreated idiopathic ischemic dilated cardiomyopathy mild (NYHA class I-II, ejection fraction < 50%) (HF) normal subjects, who had been previously maintained 100 NaCl diet. In associated significant increases echocardiographically measured left ventricular end-diastolic volume, fraction, stroke volume (all P .001) reduction total peripheral resistance (P .001). addition, plasma atrial natriuretic factor (ANF) levels increased .05), renin activity aldosterone concentrations fell (both normals excess. HF patients, both end-systolic volumes diet, whereas failed increase, did not change during ANF rise loading, as much suppressed normals. Although urinary excretions significantly different two groups, there small but systematic daily excretion HF, which resulted higher cumulative balance than period CONCLUSIONS These results show reduced load cardiac adaptations excess congestion.