BERTRAND METTAUER, M.D.; JEAN-LUCIEN ROULEAU, M.D.; DANIEL BICHET, M.D.; CARL JUNEAU, M.D.; CLAUDE KORTAS, M.D.; JEAN-NOEL BARJON, M.D.; JACQUES de CHAMPLAIN, M.D., Ph.D.
The renal hemodynamic and neurohumoral determinants of sodium and water excretion abnormalities were studied in 66 patients with severe chronic congestive heart failure. Abnormalities were not closely related to any one variable but were the result of the convergence of a number of determinants. The most important determinants for sodium excretion were activation of the renin-angiotensin system and ventricular function; and the most important for water excretion were plasma vasopressin, plasma norepinephrine, and renal and ventricular functions. In a subgroup of patients, neurohumoral overactivation led to severe sodium and water excretion abnormalities and to increased furosemide requirements. A 17-month follow-up of all 66 patients showed a less favorable clinical course for this subgroup even when compared with hemodynamically matched patients.
METTAUER B, ROULEAU J, BICHET D, et al. Sodium and Water Excretion Abnormalities in Congestive Heart Failure: Determinant Factors and Clinical Implications. Ann Intern Med. 1986;105:161–167. doi: https://doi.org/10.7326/0003-4819-105-2-161
Download citation file:
Published: Ann Intern Med. 1986;105(2):161-167.
Cardiology, Heart Failure.
Results provided by:
Copyright © 2020 American College of Physicians. All Rights Reserved.
Print ISSN: 0003-4819 | Online ISSN: 1539-3704
Conditions of Use