心力衰竭患者的膳食钠和液体摄入。欧洲心脏病学会心力衰竭协会的临床共识声明。

Dietary sodium and fluid intake in heart failure. A clinical consensus statement of the Heart Failure Association of the ESC.

作者信息

Mullens Wilfried, Damman Kevin, Dhont Sebastiaan, Banerjee Debasish, Bayes-Genis Antoni, Cannata Antonio, Chioncel Ovidiu, Cikes Maja, Ezekowitz Justin, Flammer Andreas J, Martens Pieter, Mebazaa Alexandre, Mentz Robert J, Miró Òscar, Moura Brenda, Nunez Julio, Ter Maaten Jozine M, Testani Jeffrey, van Kimmenade Roland, Verbrugge Frederik H, Metra Marco, Rosano Giuseppe M C, Filippatos Gerasimos

机构信息

Department of Cardiology, Ziekenhuis Oost-Limburg A.V, Genk, Belgium.

Hasselt University, Hasselt, Belgium.

出版信息

Eur J Heart Fail. 2024 Apr;26(4):730-741. doi: 10.1002/ejhf.3244. Epub 2024 Apr 12.

Abstract

Sodium and fluid restriction has traditionally been advocated in patients with heart failure (HF) due to their sodium and water avid state. However, most evidence regarding the altered sodium handling, fluid homeostasis and congestion-related signs and symptoms in patients with HF originates from untreated patient cohorts and physiological investigations. Recent data challenge the beneficial role of dietary sodium and fluid restriction in HF. Consequently, the European Society of Cardiology HF guidelines have gradually downgraded these recommendations over time, now advising for the limitation of salt intake to no more than 5 g/day in patients with HF, while contemplating fluid restriction of 1.5-2 L/day only in selected patients. Therefore, the objective of this clinical consensus statement is to provide advice on fluid and sodium intake in patients with acute and chronic HF, based on contemporary evidence and expert opinion.

摘要

由于心力衰竭(HF)患者存在钠和水潴留状态,传统上一直提倡对其进行钠和液体限制。然而,大多数关于HF患者钠处理改变、液体平衡及充血相关体征和症状的证据来自未经治疗的患者队列和生理学研究。最近的数据对饮食中钠和液体限制在HF中的有益作用提出了质疑。因此,随着时间的推移,欧洲心脏病学会HF指南逐渐降低了这些建议的级别,目前建议HF患者将盐摄入量限制在每天不超过5克,同时仅对部分患者考虑每天限制液体摄入量为1.5 - 2升。因此,本临床共识声明的目的是基于当代证据和专家意见,就急性和慢性HF患者的液体和钠摄入提供建议。

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