Abstract 12895: Tissue Sodium Content Increases With Severity of Chronic Heart Failure

• Published in: Circulation (New York, N.Y.) N.Y.), 2020-11, Vol.142 (Suppl_3 Suppl 3), p.A12895-A12895
• Main Authors: Kolwelter, Julie, Nagel, Armin, Kannenkeril, Dennis, Bosch, Agnes, Striepe, Kristina, Linz, Peter R, Ott, Christian, Bramlage, Peter, Uder, Michael, Achenbach, Stephan, Schmieder, Roland E
• Format: Article
• Language: English
• ISSN: 0009-7322; 1524-4539
• DOI: 10.1161/circ.142.suppl_3.12895

IntroductionHeart failure is strongly linked to renal sodium and water retention as well as intravascular and interstitial fluid shifts. Experimental studies demonstrated a non-osmotic sodium storage, bound to proteoglycans, in the extravascular space. New sodium magnetic resonance imaging (23Na-MRI) enables us to quantify tissue (muscle and skin) sodium content in a reliable and accurate way. HypothesisWe hypothesised that the increase of tissue sodium content is dependent on the severity of chronic heart failure (CHF). MethodsWe investigated patients with stable CHF before initiating treatment with an SGLT2-inhibitor within a prospective, placebo-controlled study. We here report the baseline data of 64 patients with CHF, defined as patients with reduced (HFrEF) or mid-range ejection fraction (HFmEF). In each patient, tissue sodium content of the lower leg was assessed non-invasively by a clinical 3.0T 23Na-MRI. The median NT-proBNP plasma level at baseline was 493.3pg/ml (IQR225.8-1122.0pg/ml) and was used as cut off value of CHF severity. ResultsOur patients (menn=54) were 66.9±8.9 years old and had NYHA class II-III; mean muscle sodium content was 19.1±3.8mmol/l and mean skin sodium content was 22.5±5.9mmol/l. Our reference for young healthy subjects are 18.7±2.0 mmol/l for muscle sodium content and 19.6±3.1 mmol/l for skin sodium content. Patients with CHF and NT-proBNP levels above the median showed higher muscle (20.2±3.5 vs 17.9±3.7mmol/l, p=0.008) and skin sodium content (24.1±6.8 vs 20.8±4.4mmol/l, p=0.005) than patients with CHF and NT-proBNP levels below the median. No difference in plasma sodium levels between the two groups (138.0±3.7 vs 138.8±2.1mmol/l, p=0.527) was observed, but patients with NT-proBNP levels above the median had lower urinary sodium excretion over 24 hours (167.0±78.8 vs 172.3±63.4mmol/l, p=0.009). Age was different in the two groups (69.88±8.2 vs 63.8±8.7, p