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Hyponatraemia in heart failure: time for new solutions?

Authors
  • Kapłon-Cieślicka, Agnieszka1
  • Soloveva, Anzhela2
  • Mareev, Yura3, 4
  • Cabac-Pogorevici, Irina5
  • Verbrugge, Frederik Hendrik6, 7
  • Vardas, Panagiotis8, 9
  • 1 1st Chair and Department of Cardiology, Medical University of Warsaw, Warsaw, Poland. , (Poland)
  • 2 Department of Cardiology, Almazov National Medical Research Centre, Saint Petersburg, Russian Federation [email protected] , (Russia)
  • 3 Department of Cardiology, National Medical Research Center for Therapy and Preventive Medicine, Moscow, Russian Federation. , (Russia)
  • 4 Robertson Centre for Biostatistics, University of Glasgow, Glasgow, UK.
  • 5 Department of Cardiology, State University of Medicine and Pharmacy 'Nicolae Testemitanu', Chisinau, Moldova (the Republic of). , (Moldova)
  • 6 Department of Cardiology, Centre for Cardiovascular Diseases, University Hospital Brussels, Jette, Belgium. , (Belgium)
  • 7 Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium. , (Belgium)
  • 8 Heart Sector, Hygeia Hospitals Groups, Athens, Greece. , (Greece)
  • 9 Medical School, Cardiology Department, University of Crete, Heraclion, Greece. , (Greece)
Type
Published Article
Journal
Heart
Publisher
BMJ
Publication Date
Jul 13, 2022
Volume
108
Issue
15
Pages
1179–1185
Identifiers
DOI: 10.1136/heartjnl-2021-320277
PMID: 34903584
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Hyponatraemia is very common in heart failure (HF), especially in decompensated patients. It is associated with increased mortality and morbidity and considered a marker of advanced disease. Recognition of hyponatraemia and its causes may help guide treatment strategy. Historically, therapy has primarily focused on water restriction, decongestion with loop diuretics in case of volume overload (dilutional hyponatraemia) and sodium repletion in case of depletion. In this review, we summarise the potential benefits of established and emerging HF therapies on sodium homeostasis, with a focus on dual vasopressin antagonists, angiotensin receptor-neprilysin inhibitors, sodium-glucose cotransporter 2 inhibitors and hypertonic saline, and propose a potential therapeutic approach for hyponatraemia in HF. © Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ.

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