Intrarenal determinants of sodium retention in mild heart failure: Effects of angiotensin-converting enzyme inhibition

Massimo Volpe, Paola Magri, Maria A E Rao, Sara Cangianiello, Luca DeNicola, Alessandro F. Mele, Bruno Memoli, Iolanda Enea, Speranza Rubattu, Bruna Gigante, Bruno Trimarco, Murray Epstein, Mario Condorelli

Research output: Contribution to journalArticle

41 Citations (Scopus)

Abstract

The onset and the mechanisms leading to Na+ retention in incipient congestive heart failure (CHF) have not been systematically investigated. To investigate renal Na+ handling in the early or mild stages of CHF, Na+ balance and renal clearances were assessed in 10 asymptomatic patients with idiopathic or ischemic dilated cardiomyopathy and mild heart failure (HF) off treatment (left ventricular ejection fraction, 29.7±2%) and in 10 matched normal subjects during a diet containing 100 mmol/d of NaCl and after 8 days of high salt intake (250 mmol/d). Six patients were studied again after 6 weeks of treatment with enalapril (5 mg/d PO). At the end of the high salt diet, in patients with mild HF the cumulative Na+ balance exceeded by 110 mmol that of normal subjects (F=3.86, P+ in the two groups, fractional excretion of Na+, fractional clearance of free water, and fractional excretion of K+ (indexes of distal delivery of Na+) increased in normal subjects and were reduced in patients with mild HF. During enalapril treatment, in the mild HF patients the cumulative Na+ balance was restored to normal; furthermore, enalapril significantly attenuated the abnormalities in the distal delivery of Na+. Our results indicate that a defective adaptation of Na+ reabsorption in the proximal nephron is associated with Na+ retention in response to increased salt intake in the early or mild stages of HF. These abnormalities of renal Na+ handling are largely reversed by enalapril.

Original languageEnglish
Pages (from-to)168-176
Number of pages9
JournalHypertension
Volume30
Issue number2
Publication statusPublished - Aug 1997

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Peptidyl-Dipeptidase A
Heart Failure
Sodium
Enalapril
Salts
Kidney
Diet
Nephrons
Dilated Cardiomyopathy
Stroke Volume
Therapeutics
Water

Keywords

  • Cardiomyopathy
  • Catecholamines
  • Kidney
  • Natriuretic peptides
  • Renin- angiotensin system

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Volpe, M., Magri, P., Rao, M. A. E., Cangianiello, S., DeNicola, L., Mele, A. F., ... Condorelli, M. (1997). Intrarenal determinants of sodium retention in mild heart failure: Effects of angiotensin-converting enzyme inhibition. Hypertension, 30(2), 168-176.

Intrarenal determinants of sodium retention in mild heart failure : Effects of angiotensin-converting enzyme inhibition. / Volpe, Massimo; Magri, Paola; Rao, Maria A E; Cangianiello, Sara; DeNicola, Luca; Mele, Alessandro F.; Memoli, Bruno; Enea, Iolanda; Rubattu, Speranza; Gigante, Bruna; Trimarco, Bruno; Epstein, Murray; Condorelli, Mario.

In: Hypertension, Vol. 30, No. 2, 08.1997, p. 168-176.

Research output: Contribution to journalArticle

Volpe, M, Magri, P, Rao, MAE, Cangianiello, S, DeNicola, L, Mele, AF, Memoli, B, Enea, I, Rubattu, S, Gigante, B, Trimarco, B, Epstein, M & Condorelli, M 1997, 'Intrarenal determinants of sodium retention in mild heart failure: Effects of angiotensin-converting enzyme inhibition', Hypertension, vol. 30, no. 2, pp. 168-176.
Volpe, Massimo ; Magri, Paola ; Rao, Maria A E ; Cangianiello, Sara ; DeNicola, Luca ; Mele, Alessandro F. ; Memoli, Bruno ; Enea, Iolanda ; Rubattu, Speranza ; Gigante, Bruna ; Trimarco, Bruno ; Epstein, Murray ; Condorelli, Mario. / Intrarenal determinants of sodium retention in mild heart failure : Effects of angiotensin-converting enzyme inhibition. In: Hypertension. 1997 ; Vol. 30, No. 2. pp. 168-176.
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