所属 医学部 医学科（東京女子医科大学病院） 職種 講師
|発表タイトル||Aggressive Sodium Restriction in Chronic Heart Failure: 6g vs. 3g a Randomized Study|
|会議名||ACC.19 (68th Annual Scientific Session & Expo)|
|主催者||American College of Cardiology|
|発表者・共同発表者||SEKIGUCHI Haruki, ◎KOBAYASHI Ken, KIMURA Makiko, FUKUSHIMA Tatsuya, SUZUKI Atsushi, SHIGA Tsuyoshi, HAGIWARA Nobuhisa|
|New Orleans, USA|
|学会抄録||Journal of the American College of Cardiology 73(9),812 2019|
|概要||*Session Title: Heart Failure and Cardiomyopathies: Therapy 2
Background: There is limited evidence to support the recommendation that patients with chronic heart failure (HF) in our country should restrict sodium intake. This study aimed to compare the effect of an aggressive sodium-restricted 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.
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) (ΔBNP 79 pg/mL) and BW (ΔBW 1.6 ± 1.5 kg) was observed in 3G group, compared to 6G group (ΔBNP 8 pg/dL, ΔBW 1.3 ± 2.1 kg) (p = 0.03 and p < 0.5, respectively). No patient in any of the groups showed hyponatremia.
Conclusion: Aggressive sodium restriction did not affect clinical stability of the patients, although it significantly decreased their BNP levels and body weight in just 7 days.