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

Hammon, M.; Grossmann, S.; Linz, P.; Kopp, C.; Dahlmann, A.; Garlichs, C.; Janka, R.; Cavallaro, A.; Luft, F.C.; Uder, M.; Titze, J.

(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., Grossmann, S., Linz, P., Kopp, C., Dahlmann, A., Garlichs, C., Janka, R., Cavallaro, A., Luft, F.C., 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
ISSN:	1932-6203
Publisher:	Public Library of Science
Volume:	10
Number:	10
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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