Impact of Hypotonic Hyponatremia on Outcomes in Patients Undergoing Transcatheter Aortic Valve Replacement: a National Inpatient Sample

Overview

Journal BMC Cardiovasc Disord

Publisher Biomed Central

Specialty Cardiology & Vascular Diseases

Date 2025 Mar 11

PMID 40065236

Authors

Shizhe Fu

Kairu Wang

Xueping Ma

Bo Shi

Congyan Ye

Rui Yan

Ru Yan

Shaobin Jia

Guangzhi Cong

Israel Gitangaza

Abdul Rehman

Affiliations

Soon will be listed here.

Abstract

Background: Transcatheter aortic valve replacement (TAVR) has emerged as a major therapeutic option for treating aortic stenosis. Hyponatremia is a common electrolyte disorder closely associated with adverse cardiovascular outcomes. However, large-scale studies investigating the impact of hypotonic hyponatremia on outcomes among TAVR patients are lacking.

Methods: We queried patients who underwent TAVR with concomitant hypo-osmolar hyponatremia (defined as a serum sodium concentration < 135 mEq/L with a serum osmolality < 280 mOsm/kg) using the National Inpatient Sample (2016-2021). Multivariate regression analysis and 1:1 propensity score matching (PSM) were performed to assess the associations between hypo-osmolar hyponatremia and in-hospital mortality and major adverse events (including acute kidney injury [AKI], acute myocardial infarction [AMI], and cardiogenic shock [CS]). Furthermore, sensitivity analysis was performed to assess the robustness of the findings.

Results: Among the total weighted national estimate of 370,680 patients who underwent TAVR, 13,865 (3.7%) had concomitant hypo-osmolar hyponatremia. These patients had a significantly increased risk of in-hospital mortality (aOR: 1.37; 95% CI: 1.08-1.74) and a greater likelihood of developing AKI (aOR: 3.39; 95% CI: 3.07-3.74), AMI (aOR: 3.20; 95% CI: 2.77-3.70), and CS (aOR: 2.96; 95% CI: 2.52-3.47). After PSM and sensitivity analysis, these associations remained significant.

Conclusion: In TAVR patients, hypo-osmolar hyponatremia is associated with increased in-hospital mortality and adverse events, including AKI, AMI, and CS.

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