TY - JOUR
T1 - Correction of dilutional hyponatremia in severe chronic heart failure by converting-enzyme inhibition
AU - Packer, M.
AU - Medina, N.
AU - Yushak, M.
PY - 1984/1/1
Y1 - 1984/1/1
N2 - To determine the effects of vasodilator and inotropic therapy on hyponatremia in patients with severe heart failure, we measured serum sodium concentration before and after treatment with captopril (70 patients), hydralazine (42 patients), prazosin (22 patients), and amrinone (19 patients), while diuretic dosages were kept constant. Serum sodium concentration increased only in hyponatremic patients treated with captopril (131.2 ± 0.5 to 135.9 ± 0.5 SE; p < 0.001), but not during therapy with the other agents and not in patients with normal serum sodium concentration before treatment. Serum sodium began to rise 48 hours after the initiation of captopril therapy and reached its peak after 14 to 16 days. Correction of hyponatremia was related to functional interference with the renin-angiotensin system, but not to changes in renal function, serum potassium concentration, body weight, or the magnitude of hemodynamic or clinical improvement. These findings support experimental evidence that the renin-angiotensin system is important in the pathogenesis of hyponatremia in patients with severe heart failure treated with diuretics.
AB - To determine the effects of vasodilator and inotropic therapy on hyponatremia in patients with severe heart failure, we measured serum sodium concentration before and after treatment with captopril (70 patients), hydralazine (42 patients), prazosin (22 patients), and amrinone (19 patients), while diuretic dosages were kept constant. Serum sodium concentration increased only in hyponatremic patients treated with captopril (131.2 ± 0.5 to 135.9 ± 0.5 SE; p < 0.001), but not during therapy with the other agents and not in patients with normal serum sodium concentration before treatment. Serum sodium began to rise 48 hours after the initiation of captopril therapy and reached its peak after 14 to 16 days. Correction of hyponatremia was related to functional interference with the renin-angiotensin system, but not to changes in renal function, serum potassium concentration, body weight, or the magnitude of hemodynamic or clinical improvement. These findings support experimental evidence that the renin-angiotensin system is important in the pathogenesis of hyponatremia in patients with severe heart failure treated with diuretics.
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U2 - 10.7326/0003-4819-100-6-782
DO - 10.7326/0003-4819-100-6-782
M3 - Article
C2 - 6326629
AN - SCOPUS:0021259537
SN - 0003-4819
VL - 100
SP - 782
EP - 789
JO - Annals of internal medicine
JF - Annals of internal medicine
IS - 6
ER -