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(23)Na magnetic resonance imaging of the lower leg of acute heart failure patients during diuretic treatment

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Item Type:Article
Title:(23)Na magnetic resonance imaging of the lower leg of acute heart failure patients during diuretic treatment
Creators Name:Hammon, M. and Grossmann, S. and Linz, P. and Kopp, C. and Dahlmann, A. and Garlichs, C. and Janka, R. and Cavallaro, A. and Luft, F.C. and Uder, M. and Titze, J.
Abstract:OBJECTIVE: Na+ can be stored in muscle and skin without commensurate water accumulation. The aim of this study was to assess Na+ and H2O in muscle and skin with MRI in acute heart failure patients before and after diuretic treatment and in a healthy cohort. METHODS: Nine patients (mean age 78 years; range 58-87) and nine age and gender-matched controls were studied. They underwent 23Na/1H-MRI at the calf with a custom-made knee coil. Patients were studied before and after diuretic therapy. 23Na-MRI gray-scale measurements of Na+-phantoms served to quantify Na+-concentrations. A fat-suppressed inversion recovery sequence was used to quantify H2O content. RESULTS: Plasma Na+-levels did not change during therapy. Mean Na+-concentrations in muscle and skin decreased after furosemide therapy (before therapy: 30.7+/-6.4 and 43.5+/-14.5 mmol/L; after therapy: 24.2+/-6.1 and 32.2+/-12.0 mmol/L; p<0.05 and p<0.01). Water content measurements did not differ significantly before and after furosemide therapy in muscle (p = 0.17) and only tended to be reduced in skin (p = 0.06). Na+-concentrations in calf muscle and skin of patients before and after diuretic therapy were significantly higher than in healthy subjects (18.3+/-2.5 and 21.1+/-2.3 mmol/L). CONCLUSIONS: 23Na-MRI shows accumulation of Na+ in muscle and skin in patients with acute heart failure. Diuretic treatment can mobilize this Na+-deposition; however, contrary to expectations, water and Na+-mobilization are poorly correlated.
Keywords:Case-Control Studies, Diuretics, Heart Failure, Leg, Magnetic Resonance Imaging, Prospective Studies, Skeletal Muscle, Skin, Sodium, Water
Source:PLoS ONE
Publisher:Public Library of Science
Page Range:e0141336
Date:26 October 2015
Official Publication:https://doi.org/10.1371/journal.pone.0141336
PubMed:View item in PubMed

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