title: B-type natriuretic peptide levels are decreased by reducing dietary salt intake in patients with compensated heart failure with preserved ejection fraction.
abstract: BACKGROUND
  Dietary salt restriction is believed to be a mainstay in the management of patients with heart failure. However, the effect of salt intake on heart failure has not been well evaluated in outpatient medical practice.
  
  
  OBJECTIVE
  The aim of the present study was to assess the hypothesis that B-type natriuretic peptide (BNP) level, as an objective marker of heart failure, is associated with salt intake in patients with heart failure.
  
  
  METHODS
  One hundred and thirteen consecutive patients with mild compensated heart failure (77 ± 10 years old, 51 female) were included. We estimated dietary salt intake by the concentration of sodium and creatinine in spot urine. We measured BNP at the time of urine sampling and assessed the relationship between the % changes in BNP levels (%ΔBNP) and the changes in the estimated daily salt excretion (ΔNaCl) during the follow-up period.
  
  
  RESULTS
  The baseline median BNP level was 150 (interquartile range: 83-263) pg/mL and the estimated daily salt excretion was 162 ± 45 mmol/day. There was a positive correlation between %ΔBNP and ΔNaCl (r = 0.61, P < 0.01). Multiple regression analysis revealed that %ΔBNP was associated with ΔNaCl (P < 0.01), but not with changes in systolic blood pressure and bodyweight.
  
  
  CONCLUSIONS
  Changes in BNP levels were associated with changes in the estimated daily salt excretion in outpatients with compensated heart failure. Salt restriction may be beneficial for the management of patients with heart failure.
authors.affiliation: Division of Cardiology, Ueki Hospital, Kumamoto, Japan. kamefu@rb3.so-net.ne.jp
authors.forename: T
authors.initials: T
authors.lastname: Sadanaga
authors.forename: K
authors.initials: K
authors.lastname: Ando
authors.forename: S
authors.initials: S
authors.lastname: Hirota
authors.forename: H
authors.initials: H
authors.lastname: Mitamura
authors.forename: T
authors.initials: T
authors.lastname: Tsuchihashi
authors.forename: S
authors.initials: S
authors.lastname: Kohsaka
authors.forename: K
authors.initials: K
authors.lastname: Fukuda
authors.forename: S
authors.initials: S
authors.lastname: Ogawa
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000652:urine; D005260:Female; D006333:Heart Failure / Q000178:diet therapy* / Q000652:urine*; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000652:urine*; D011446:Prospective Studies; D017673:Sodium Chloride, Dietary / Q000008:administration & dosage* / Q000652:urine*; D013318:Stroke Volume / Q000502:physiology*
chemical_list: D015415:Biomarkers; D017673:Sodium Chloride, Dietary; D020097:Natriuretic Peptide, Brain