Evidence map›Paper›PMID 34490604›Full record

Trial reportCardiology journal2023

Sodium restriction in patients with chronic heart failure and reduced ejection fraction: A randomized controlled trial.

Juan B Ivey-Miranda, Eduardo Almeida-Gutierrez, Raul Herrera-Saucedo, Edith L Posada-Martinez, Adolfo Chavez-Mendoza, Genaro H Mendoza-Zavala, Jose A Cigarroa-Lopez, Jose A Magaña-Serrano, Roxana Rivera-Leaños, Alberto Treviño-Mejia and 9 more

Registry-linked trialAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Cardiology journal, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03351283 (Effect of Moderate vs Severe Sodium Restriction on Brain Natriuretic Peptide in Patients With Heart Failure and Reduced Ejection Fraction), which is not on this map. Cited by 10 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03351283 nacompletednot on this map

Effect of Moderate vs Severe Sodium Restriction on Brain Natriuretic Peptide in Patients With Heart Failure and Reduced Ejection Fraction

TypeinterventionalSponsorInstituto Mexicano del Seguro SocialRan2017 to 2020Enrolled70ConditionsDiet, Sodium-Restricted, Heart Failure, Systolic, Natriuretic Peptide, Brain, Clinical TrialArmsSevere sodium restriction, Moderate sodium restriction
3 · Its place in the literature

Who cites it

10 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Role of dietary sodium restriction in chronic heart failure: systematic review and meta-analysis.Clinical research in cardiology : official journal of the German Cardiac Society · 2024
    Pooled it
  3. Article
  4. Review
  5. Review
  6. Review
  7. Safety and Efficacy of Salt Restriction Across the Spectrum of Heart Failure.Journal of cardiovascular development and disease · 2025
    Review
  8. Article
  9. Review
  10. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors.

Juan B Ivey-MirandaDepartment of Heart Failure, Hospital de Cardiologia, Centro Medico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico. betuel.ivey@gmail.com.
Eduardo Almeida-GutierrezDepartment of Research and Direction, Hospital de Cardiologia, Centro Medico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico.
Raul Herrera-SaucedoDepartment of Heart Failure, Hospital de Cardiologia, Centro Medico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico.
Edith L Posada-MartinezDepartment of Echocardiography, Instituto Nacional de Cardiologia Ignacio Chavez, Mexico City, Mexico.
Adolfo Chavez-MendozaDepartment of Heart Failure, Hospital de Cardiologia, Centro Medico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico.
Genaro H Mendoza-ZavalaDepartment of Heart Failure, Hospital de Cardiologia, Centro Medico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico.
Jose A Cigarroa-LopezDepartment of Heart Failure, Hospital de Cardiologia, Centro Medico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico.
Jose A Magaña-SerranoDepartment of Heart Failure, Hospital de Cardiologia, Centro Medico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico.
Roxana Rivera-LeañosDepartment of Laboratory, Hospital de Cardiologia, Centro Medico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico.
Alberto Treviño-MejiaDepartment of Laboratory, Hospital de Cardiologia, Centro Medico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico.
Cristina Revilla-MatuteUnidad de Investigación Médica en Enfermedades Metabólicas, Hospital de Cardiologia, Centro Medico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico.
Eduardo J Flores-UmanzorDepartment of Cardiology. Hospital Clinic de Barcelona, Barcelona, Spain.
Nilda Espinola-ZavaletaDepartment of Nuclear Medicine, Instituto Nacional de Cardiologia Ignacio Chavez, Mexico City, Mexico.
Arturo Orea-TejedaHead of Cardiology Department, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Mexico City, Mexico.
Juan Garduño-EspinosaDirectorate of Research, Hospital Infantil de México Federico Gómez, Mexico City, Mexico.
Guillermo Saturno-ChiuDepartment of Research and Direction, Hospital de Cardiologia, Centro Medico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico.
Veena S RaoDepartment of Internal Medicine, Section of Cardiovascular Medicine, Yale University School of Medicine, New Haven, Connecticut, United States.
Jeffrey M TestaniDepartment of Internal Medicine, Section of Cardiovascular Medicine, Yale University School of Medicine, New Haven, Connecticut, United States.
Gabriela Borrayo-SanchezProgram "A Todo Corazon", Centro Medico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSodium restriction is recommended for patients with heart failure (HF) despite the lack of solid clinical evidence from randomized controlled trials. Whether or not sodium restrictions provide beneficial cardiac effects is not known.

methodsThe present study is a randomized, double-blind, controlled trial of stable HF patients with ejection fraction ≤ 40%. Patients were allocated to sodium restriction (2 g of sodium/day) vs. control (3 g of sodium/day). The primary outcome was change in N-terminal pro-B-type natriuretic peptide (NT-proBNP) at 20 weeks. Secondary outcomes included quality of life and adverse safety events (HF readmission, blood pressure or electrolyte abnormalities).

resultsSeventy patients were enrolled. Median baseline sodium consumption was 3268 (2225-4537) mg/day. Adherence to the intervention based on 24-hour urinary sodium was 32%. NT-proBNP and quality of life did not significantly change between groups (p > 0.05 for both). Adverse safety events were not significantly different between the arms (p > 0.6 for all). In the per protocol analysis, patients who achieved a sodium intake < 2500 mg/day at the intervention conclusion showed improvements in NT-proBNP levels (between-group difference: -55%, 95% confidence interval -27 to -73%; p = 0.002) and quality of life (between-group difference: -11 ± 5 points; p = 0.04). Blood pressure decreased in patients with lower sodium intake (between-group difference: -9 ± 5 mmHg; p = 0.05) without significant differences in symptomatic hypotension or other safety events (p > 0.3 for all).

conclusionsAdherence assessed by 24-hour natriuresis and by the nutritionist was poor. The group allocated to sodium restriction did not show improvement in NT-proBNP. However, patients who achieved a sodium intake < 2500 mg/day appeared to have improvements in NT-proBNP and quality of life without any adverse safety signals. CLINICALTRIALS: gov Identifier: NCT03351283.

Indexed as

Heart FailureSodium, DietaryBiomarkersHumansNatriuretic Peptide, BrainPeptide FragmentsQuality of LifeSodiumStroke VolumeBiomarkersNatriuretic Peptide, BrainPeptide FragmentsSodiumSodium, Dietaryheart failureNT-proBNPquality of lifesodium intake

Identifiers

PMID34490604
PMCPMC10287066

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.