Namik Kemal University Faculty of Medicine - Cardiology, Tekirdag - Turquia.
Istanbul University Istanbul Faculty of Medicine - Cardiology, Istanbul - Turquia.
Arq Bras Cardiol. 2022 Apr;118(4):712-718. doi: 10.36660/abc.20210139.
The coexistence of hyponatremia and atrial fibrillation (AF) increases morbidity and mortality in patients with heart failure (HF). However, it is not established whether hyponatremia is related to AF or not.
Our study aims to seek a potential association of hyponatremia with AF in patients with reduced ejection fraction heart failure (HFrEF).
This observational cross-sectional single-center study included 280 consecutive outpatients diagnosed with HFrEF with 40% or less. Based on sodium concentrations ≤135 mEq/L or higher, the patients were classified into hyponatremia (n=66) and normonatremia (n=214). A p-value <0.05 was considered significant.
Mean age was 67.6±10.5 years, 202 of them (72.2%) were male, mean blood sodium level was 138±3.6 mEq/L, and mean ejection fraction was 30±4%. Of those, 195 (69.6%) patients were diagnosed with coronary artery disease. AF was detected in 124 (44.3%) patients. AF rate was higher in patients with hyponatremia compared to those with normonatremia (n=39 [59.1%] vs. n=85 [39.7%), p= 0.020). In the logistic regression analysis, hyponatremia was not related to AF (OR=1.022, 95% CI=0.785-1.330, p=0.871). Advanced age (OR=1.046, 95% CI=1.016-1.177, p=0.003), presence of CAD (OR=2.058, 95% CI=1.122-3.777, p=0.020), resting heart rate (OR=1.041, 95% CI=1.023-1.060, p<0.001), and left atrium diameter (OR=1.049, 95% CI=1.011-1.616, p=0.002) were found to be predictors of AF.
AF was higher in outpatients with HFrEF and hyponatremia. However, there is no association between sodium levels and AF in patients with HFrEF.
低钠血症和心房颤动（AF）共存会增加心力衰竭（HF）患者的发病率和死亡率。然而，低钠血症是否与 AF 有关尚不确定。
本研究旨在探讨射血分数降低的心力衰竭（HFrEF）患者中低钠血症与 AF 之间的潜在关联。
这是一项观察性、横断面、单中心研究，共纳入 280 例连续就诊的射血分数为 40%或更低的 HFrEF 门诊患者。根据钠浓度≤135 mEq/L 或更高，将患者分为低钠血症组（n=66）和正常钠血症组（n=214）。p 值<0.05 被认为具有统计学意义。
患者平均年龄为 67.6±10.5 岁，202 例（72.2%）为男性，平均血钠水平为 138±3.6 mEq/L，平均射血分数为 30±4%。其中，195 例（69.6%）患者被诊断为冠状动脉疾病。124 例（44.3%）患者存在 AF。与正常钠血症组相比，低钠血症组的 AF 发生率更高（n=39[59.1%] vs. n=85[39.7%]，p=0.020）。在 logistic 回归分析中，低钠血症与 AF 无相关性（OR=1.022，95%CI=0.785-1.330，p=0.871）。高龄（OR=1.046，95%CI=1.016-1.177，p=0.003）、存在 CAD（OR=2.058，95%CI=1.122-3.777，p=0.020）、静息心率（OR=1.041，95%CI=1.023-1.060，p<0.001）和左心房直径（OR=1.049，95%CI=1.011-1.616，p=0.002）是 AF 的预测因素。
HFrEF 门诊患者中低钠血症和 AF 的发生率较高。然而，在 HFrEF 患者中，钠水平与 AF 之间没有关联。
