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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 J+Clin+Med
2015 ; 4
(5
): 933-47
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Hyponatremia Associated with Heart Failure: Pathological Role of
Vasopressin-Dependent Impaired Water Excretion
#MMPMID26239456
Ishikawa SE
J Clin Med
2015[May]; 4
(5
): 933-47
PMID26239456
show ga
An exaggerated increase in circulatory blood volume is linked to congestive heart
failure. Despite this increase, reduction of the "effective circulatory blood
volume" in congestive heart failure is associated with decreased cardiac output,
and can weaken the sensitivity of baroreceptors. Thereafter, tonic inhibition of
the baroreceptor-mediated afferent pathway of vagal nerves is removed, providing
an increase in non-osmotic release of arginine vasopressin (AVP). In the renal
collecting duct, the aquaporin-2 (AQP2) water channel is regulated by sustained
elevation of AVP release, and this leads to augmented hydroosmotic action of AVP,
that results in exaggerated water retention and dilutional hyponatremia.
Hyponatremia is also a predictor for worsening heart failure in patients with
known/new onset heart failure. Therefore, such a dilutional hyponatremia
associated with organ damage is predictive of the short- and long-term outcome of
heart failure.