Key result
This review summarizes the potential benefits of established and emerging heart failure therapies on sodium homeostasis and proposes a therapeutic approach for hyponatremia in heart failure.
Why the study?
Hyponatraemia is common and associated with increased morbidity and mortality in heart failure, and recognition of its causes may guide treatment beyond historical approaches.
This review outlines how emerging heart failure therapies, including ARNI and SGLT2 inhibitors, may benefit sodium homeostasis and help manage hyponatremia.
May guide hyponatremia management in HF with ARNI/SGLT2i; leaves open prospective validation.
Hyponatraemia is very common in heart failure (HF), especially in decompensated patients. It is associated with increased mortality and morbidity and considered a marker of advanced disease. Recognition of hyponatraemia and its causes may help guide treatment strategy. Historically, therapy has primarily focused on water restriction, decongestion with loop diuretics in case of volume overload (dilutional hyponatraemia) and sodium repletion in case of depletion. In this review, we summarise the potential benefits of established and emerging HF therapies on sodium homeostasis, with a focus on dual vasopressin antagonists, angiotensin receptor-neprilysin inhibitors, sodium-glucose cotransporter 2 inhibitors and hypertonic saline, and propose a potential therapeutic approach for hyponatraemia in HF.
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Kapłon‐Cieślicka et al. (2021) conducted a review in Heart failure with hyponatraemia. Heart failure therapies (dual vasopressin antagonists, ARNI, SGLT2 inhibitors, hypertonic saline) was evaluated. This review summarizes the potential benefits of established and emerging heart failure therapies on sodium homeostasis and proposes a therapeutic approach for hyponatremia in heart failure.
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