キムラ　マキコ   KOBAYASHI Makiko   木村　眞樹子    所属   医学部 医学科（東京女子医科大学病院）    職種   非常勤講師
言語種別	日本語
発表タイトル	Aggressive Sodium Restriction in Chronic Heart Failure: 6g vs. 3g a Randomized Clinical Trial
会議名	第83回日本循環器学会学術集会
主催者	日本循環器学会
学会区分	全国規模の学会
発表形式	口頭
講演区分	一般
発表者・共同発表者	◎小林献, 関口治樹, 木村眞樹子, 福島立也, 鈴木敦, 志賀剛, 萩原誠久
発表年月日	2019/03/30
開催地 （都市, 国名）	横浜市
概要	*Oral Presentation (Japanese)27 Heart Failure (Non-Pharmacology) Background: There is limited evidence to support the recommendation that patients with chronic heart failure(HF) in our country should restrict sodium intake. Aims: This study aimed to compare the effect of an aggressive sodiumrestricted diet(3 g/day of sodium intake [3G]) and a normal sodium-restricted diet (6 g/day of sodium intake [6G]) on weight loss and clinical stability during a 7-day period in patients hospitalized with HF. Design: Randomized, openlabeled clinical trial Methods: In total, 142 stable hospitalized patients classified as NYHA class II-IV were randomized to 3G or 6G and followed up for 7 days. The primary endpoint was clinical congestion score(CCS) at the 7-day assessment. We also evaluated weight loss, several biomarkers, and bioelectrical impedance. Results: A total of 71 patients were enrolled in each group. There were differences in age, sex, body weight (BW),BMI,NYHA class,CCS, and cause of heart failure between the groups. Patients from both groups showed significantly improved CCS compared to that at the baseline (3G: 3.2 to 1.9; p<0.05, 6G: 3.4 to 2.1; p<0.05). There were no significant differences in the change of CCS between the groups. However, a significant decrease in the levels of brain-type natriuretic peptide(BNP)(∆BNP 79pg/mL) and BW(∆BW 1.6±1.5kg) was observed in 3G group, compared to 6G group(∆BNP 8pg/dL,∆BW 1.3±2.1kg)(p=0.03 and p<0.5, respectively). No patient in any of the groups showed hyponatremia. Conclusions: While aggressive sodium restriction did not affect clinical stability of the patients, it significantly decreased their BNP levels and body weight in just 7 days. Therefore, we can conclude that aggressive sodium restriction is beneficial for patients with chronic HF.