Skip to main content
NCBI home page
British Heart Journal logoLink to British Heart Journal
. 1982 Feb;47(2):161–166. doi: 10.1136/hrt.47.2.161

Hyponatraemia as a marker for high renin heart failure.

T B Levine, J A Franciosa, T Vrobel, J N Cohn
PMCID: PMC481114  PMID: 7037024

Abstract

The factors that might activate the renin-angiotensin system in treated heart failure were explored. Serum Na+ correlated inversely with plasma renin activity. The degree of congestive heart failure measured by right atrial pressure, pulmonary capillary wedge pressure, cardiac index, and systemic vascular resistance did not correlate with plasma renin activity. Similarly, renal function as measured by blood urea nitrogen, creatinine, and urinary Na+ excretion did not correlate with plasma renin activity. In a prospectively screened group, seven patients with congestive heart failure who were found to be hyponatraemic had plasma renin activities greater than 15 ng/ml per h. Serial determinations in one patient showed plasma renin activity to vary inversely with the serum Na+. It is concluded that serum sodium can be used to identify those patients with congestive heart failure who have a high plasma renin activity. The value of identifying these high renin heart failure patients was seen in their response in four cases to specific therapy with a converting enzyme inhibitor.

Full text

PDF
161

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Abbrecht P. H., Vander A. J., Turcotte J. G. Effects of saline loading on the renin, erythropoietin, and blood pressure responses to canine renal allotransplantation. Circ Res. 1969 Aug;25(2):99–105. doi: 10.1161/01.res.25.2.99. [DOI] [PubMed] [Google Scholar]
  2. Ader R., Chatterjee K., Ports T., Brundage B., Hiramatsu B., Parmley W. Immediate and sustained hemodynamic and clinical improvement in chronic heart failure by an oral angiotensin-converting enzyme inhibitor. Circulation. 1980 May;61(5):931–937. doi: 10.1161/01.cir.61.5.931. [DOI] [PubMed] [Google Scholar]
  3. Andersson B. Regulation of water intake. Physiol Rev. 1978 Jul;58(3):582–582. doi: 10.1152/physrev.1978.58.3.582. [DOI] [PubMed] [Google Scholar]
  4. Atkinson A. B., Davies D. L., Leckie B., Morton J. J., Brown J. J., Fraser R., Lever A. F., Robertson J. I. Hyponatraemic hypertensive syndrome with renal-artery occlusion corrected by captopril. Lancet. 1979 Sep 22;2(8143):606–609. doi: 10.1016/s0140-6736(79)91666-0. [DOI] [PubMed] [Google Scholar]
  5. BROWN J. J., DAVIES D. L., LEVER A. F., ROBERTSON J. I. PLASMA RENIN CONCENTRATION IN HUMAN HYPERTENSION. 1. RELATIONSHIP BETWEEN RENIN, SODIUM, AND POTASSIUM. Br Med J. 1965 Jul 17;2(5454):144–148. doi: 10.1136/bmj.2.5454.144. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Black D. A. Renal rete mirabile. Lancet. 1965 Dec 4;2(7423):1141–1151. doi: 10.1016/s0140-6736(65)92558-4. [DOI] [PubMed] [Google Scholar]
  7. Blaine E. H., Davis J. O., Witty R. T. Renin release after hemorrhage and after suprarenal aortic constriction in dogs without sodium delivery to the macula densa. Circ Res. 1970 Dec;27(6):1081–1089. doi: 10.1161/01.res.27.6.1081. [DOI] [PubMed] [Google Scholar]
  8. Brown J. J., Davies D. L., Johnson V. W., Lever A. F., Robertson J. I. Renin relationships in congestive cardiac failure, treated and untreated. Am Heart J. 1970 Sep;80(3):329–342. doi: 10.1016/0002-8703(70)90098-0. [DOI] [PubMed] [Google Scholar]
  9. Brown J. J., Lever A. F., Davies D. L., Robertson J. I. Renin and angiotensin. A survey of some aspects. Postgrad Med J. 1966 Mar;42(485):153–176. doi: 10.1136/pgmj.42.485.153. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Cohn J. N. Blood pressure and cardiac performance. Am J Med. 1973 Sep;55(3):351–361. doi: 10.1016/0002-9343(73)90135-6. [DOI] [PubMed] [Google Scholar]
  11. Cohn J. N., Mashiro I., Levine T. B., Mehta J. Role of vasoconstrictor mechanisms in the control of left ventricular performance of the normal and damaged heart. Am J Cardiol. 1979 Oct 22;44(5):1019–1022. doi: 10.1016/0002-9149(79)90238-8. [DOI] [PubMed] [Google Scholar]
  12. Curtiss C., Cohn J. N., Vrobel T., Franciosa J. A. Role of the renin-angiotensin system in the systemic vasoconstriction of chronic congestive heart failure. Circulation. 1978 Nov;58(5):763–770. doi: 10.1161/01.cir.58.5.763. [DOI] [PubMed] [Google Scholar]
  13. Davis J. O., Freeman R. H. Mechanisms regulating renin release. Physiol Rev. 1976 Jan;56(1):1–56. doi: 10.1152/physrev.1976.56.1.1. [DOI] [PubMed] [Google Scholar]
  14. Davis R., Ribner H. S., Keung E., Sonnenblick E. H., LeJemtel T. H. Treatment of chronic congestive heart failure with captopril, an oral inhibitor of angiotensin-converting enzyme. N Engl J Med. 1979 Jul 19;301(3):117–121. doi: 10.1056/NEJM197907193010301. [DOI] [PubMed] [Google Scholar]
  15. Fitzsimons J. T., Simons B. J. The effect on drinking in the rat of intravenous infusion of angiotensin, given alone or in combination with other stimuli of thirst. J Physiol. 1969 Jul;203(1):45–57. doi: 10.1113/jphysiol.1969.sp008848. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Franciosa J. A., Ragan D. O., Rubenstone S. J. Validation of the CO2 rebreathing method for measuring cardiac output in patients with hypertension or heart failure. J Lab Clin Med. 1976 Oct;88(4):672–682. [PubMed] [Google Scholar]
  17. Genest J., Granger P., De Champlain J., Boucher R. Endocrine factors in congestive heart failure. Am J Cardiol. 1968 Jul;22(1):35–42. doi: 10.1016/0002-9149(68)90244-0. [DOI] [PubMed] [Google Scholar]
  18. Gordon R. D., Pawsey C. G. The relative effects of serum sodium concentration and the state of body fluid balance on renin secretion. J Clin Endocrinol Metab. 1971 Jan;32(1):117–119. doi: 10.1210/jcem-32-1-117. [DOI] [PubMed] [Google Scholar]
  19. HADDY F. J., MOLNAR J. I., BORDEN C. W., TEXTER E. C., Jr Comparison of direct effects of angiotensin and other vasoactive agents on small and large blood vessels in several vascular beds. Circulation. 1962 Jan;25:239–246. doi: 10.1161/01.cir.25.1.239. [DOI] [PubMed] [Google Scholar]
  20. Hesse B., Nielsen I., Bollerup A. C., Olesen K. H., Uhrenholdt A. Hemodynamics, compartments and the renin-aldosterone system in chronic heart failure. Eur J Cardiol. 1975 Aug;3(2):107–115. [PubMed] [Google Scholar]
  21. LARAGH J. H. Hormones and the pathogenesis of congestive heart failure: vasopressin, aldosterone, and angiotensin II. Further evidence for renal-adrenal interaction from studies in hypertension and in cirrhosis. Circulation. 1962 Jun;25:1015–1023. doi: 10.1161/01.cir.25.6.1015. [DOI] [PubMed] [Google Scholar]
  22. Levine T. B., Franciosa J. A., Cohn J. N. Acute and long-term response to an oral converting-enzyme inhibitor, captopril, in congestive heart failure. Circulation. 1980 Jul;62(1):35–41. doi: 10.1161/01.cir.62.1.35. [DOI] [PubMed] [Google Scholar]
  23. Newsome H. H., Bartter F. C. Plasma renin activity in relation to serum sodium concentration and body fluid balance. J Clin Endocrinol Metab. 1968 Dec;28(12):1704–1711. doi: 10.1210/jcem-28-12-1704. [DOI] [PubMed] [Google Scholar]
  24. SKINNER S. L., MCCUBBIN J. W., PAGE I. H. CONTROL OF RENIN SECRETION. Circ Res. 1964 Jul;15:64–76. doi: 10.1161/01.res.15.1.64. [DOI] [PubMed] [Google Scholar]
  25. Sancho J., Re R., Burton J., Barger A. C., Haber E. The role of the renin-angiotensin-aldosterone system in cardiovascular homeostasis in normal human subjects. Circulation. 1976 Mar;53(3):400–405. doi: 10.1161/01.cir.53.3.400. [DOI] [PubMed] [Google Scholar]
  26. Sealey J. E., Gerten-Banes J., Laragh J. H. The renin system: Variations in man measured by radioimmunoassay or bioassay. Kidney Int. 1972 Apr;1(4):240–253. doi: 10.1038/ki.1972.34. [DOI] [PubMed] [Google Scholar]
  27. Shade R. E., Davis J. O., Johnson J. A., Witty R. T. Effects of renal arterial infusion of sodium and potassium on renin secretion in the dog. Circ Res. 1972 Nov;31(5):719–727. doi: 10.1161/01.res.31.5.719. [DOI] [PubMed] [Google Scholar]
  28. Tagawa H., Vander A. J., Bonjour J. P., Malvin R. L. Inhibition of renin secretion by vasopressin in unanesthetized sodium-deprived dogs. Am J Physiol. 1971 Apr;220(4):949–951. doi: 10.1152/ajplegacy.1971.220.4.949. [DOI] [PubMed] [Google Scholar]
  29. Turini G. A., Brunner H. R., Gribic M., Waeber B., Gavras H. Improvement of chronic congestive heart-failure by oral captopril. Lancet. 1979 Jun 9;1(8128):1213–1215. doi: 10.1016/s0140-6736(79)91897-x. [DOI] [PubMed] [Google Scholar]
  30. Vander A. J. Direct effects of potassium on renin secretion and renal function. Am J Physiol. 1970 Aug;219(2):455–459. doi: 10.1152/ajplegacy.1970.219.2.455. [DOI] [PubMed] [Google Scholar]
  31. Watkins L., Jr, Burton J. A., Haber E., Cant J. R., Smith F. W., Barger A. C. The renin-angiotensin-aldosterone system in congestive failure in conscious dogs. J Clin Invest. 1976 Jun;57(6):1606–1617. doi: 10.1172/JCI108431. [DOI] [PMC free article] [PubMed] [Google Scholar]
  32. Yamamoto K., Hasegawa T., Miyazaki M., Ueda J. Control of renin secretion in the anesthetized dog. 2. Relationship between renin secretion, plasma sodium concentration and GFR in the perfused kidney. Jpn Circ J. 1969 Jun;33(6):593–600. doi: 10.1253/jcj.33.593. [DOI] [PubMed] [Google Scholar]

Articles from British Heart Journal are provided here courtesy of BMJ Publishing Group

RESOURCES