High serum osmolarity at admission determines a worse outcome in patients with heart failure: Is a new target emerging?

Arévalo-Lorido, José Carlos; Gómez, Juana Carretero; Formiga, Francesç; Conde-Martel, Alicia; Carrera‐Izquierdo, Margarita; Muela-Molinero, Alberto; Dávila‐Ramos, Melitón Francisco; Serrado-Iglesias, Ana; Espinosa, Luís; Montero-Pérez-Barquero, Manuel

doi:10.1016/j.ijcard.2016.07.084

Cited by 29 publications

(36 citation statements)

References 20 publications

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“…In addition, in a cross‐sectional study which included 10602 participants, the researcher showed that increased serum osmolality was associated with decreased forced expiratory volume in one second and forced vital capacity in patients with chronic obstructive lung disease . Furthermore, the predictive value of plasma osmolality has been also examined in patients with heart failure and acute coronary syndrome . These studies reported that high plasma osmolality upon admission was associated with an increased in‐hospital mortality among these patients.…”

Section: Discussionmentioning

confidence: 99%

“…21 Furthermore, the predictive value of plasma osmolality has been also examined in patients with heart failure and acute coronary syndrome. 22,23 These studies reported that high plasma osmolality upon admission was associated with an increased in-hospital mortality among these patients. However, the suitability of plasma osmolality for the prediction of in-hospital mortality in patients with APE remains unknown.…”

Section: Discussionmentioning

confidence: 99%

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The predictive value of plasma osmolality for in‐hospital mortality in patients with acute pulmonary embolism

Öztaş¹,

Çınar²,

Hayıroğlu³

et al. 2019

Clinical Respiratory J

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Introduction and Objectives Prior studies demonstrated that plasma osmolality may have a predictive value for in‐hospital mortality in patients with heart failure and acute coronary syndrome. In addition, plasma glucose and blood urea nitrogen (BUN) levels, the components of plasma osmolality, have been shown to be an important contributor for in‐hospital mortality in acute pulmonary embolism (APE) patients. Hence, the objective of the current study is to evaluate the effect of plasma osmolality upon admission with in‐hospital mortality in patients with APE. Methods A total of 245 consecutive intermediate or high risk APE patients were enrolled into the study. The study population was divided into three tertile groups (T1, T2 and T3) based on the increased plasma osmolality. The in‐hospital mortality was the primary end‐point. Results After adjusting for all risk factors, in‐hospital mortality was significantly higher in the T3 group compared to T1 and T2 groups (OR: 3.6, 95% CI: 1.3 to 18.8, P < .001). In addition, the incidence of asystolia, hypotension and cardiogenic shock were significantly higher in the T3 group. An area under the receiver operating characteristic curve value of plasma osmolality for the in‐hospital mortality was 0.76 with sensitivity 67.2% and specificity 74.1% 95% CI: (0.66‐0.87, P < .001). Conclusion This is the first study to demonstrate that elevated levels of plasma osmolality may have a predictive value for in‐hospital mortality in APE patients. Our findings are novel and deserve further studies whether the treatment of higher plasma osmolality may reduce the risk of in‐hospital mortality in APE patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The predictive value of plasma osmolality for in‐hospital mortality in patients with acute pulmonary embolism

Öztaş¹,

Çınar²,

Hayıroğlu³

et al. 2019

Clinical Respiratory J

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“…Stability of serum osmolarity is maintained by a rapid increase or decrease in total body water content to compensate for changes in sodium intake and urinary water loss. Secretion of the antidiuretic hormone arginine vasopressin (AVP), which regulates thirst, has the major role in managing these adjustments in body water content (Arévalo-Lorido et al 2016). Dysregulation of osmolarity is associated with fluid-electrolyte imbalances, such as dehydration and hypernatraemia, leading to clinically increased risk of cardiovascular, cerebral, respiratory and renal disorders and mortality (Shen et al 2017).…”

Section: Introductionmentioning

confidence: 99%

Serum osmolarity in male patients with bipolar disorder manic episode

Kalelioğlu

Karamustafalıoğlu

Genç

et al. 2017

Experimental Physiology

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What is the central question of this study? The main goal of this study was, for the first time, to investigate the role of the serum osmolarity in bipolar disorder manic episode. What is the main finding and its importance? Our results demonstrate a diminished serum osmolarity in manic episode compared with healthy control subjects. This finding supports the hypothesis of a fluid and electrolyte imbalance during acute episodes. Decreased serum osmolarity might be a reflection of a relative haemodilution in mania. Imbalance of water and electrolyte homeostasis has been suggested to be associated with acute episodes of bipolar disorder. In this study, we aimed to investigate, for the first time, the serum osmolarity in bipolar disorder manic episode. A total of 68 bipolar inpatients in manic episode and 60 age- and sex-matched healthy control subjects were included in the study. Serum osmolarity was calculated from sodium (Na ), glucose and blood urea nitrogen (BUN) according to following formula: (2 × Na ) + (BUN/2.8) + (glucose/18). The significance level was accepted as P < 0.05. The serum osmolarity of manic patients was 295.34 ± 4.90 mosmol/l and that of the control group was 298.46 ± 5.33 mosmol/l. The serum osmolarity of the manic group was significantly lower than that of control subjects (P < 0.001). When we compared the components of serum osmolarity, a statistically significant difference was also observed between groups in terms of glucose (85.85 ± 12.25 mg/dl for manic, 92.95 ± 20.77 mg/dl for control subjects, P = 0.019) and Na (140.73 ± 2.06 mmol/l for manic, 142.06 ± 2.48 mmol/l for control subjects, P = 0.001). For BUN concentrations, there was no statistically significant difference between manic (25.50 ± 9.85 mg/dl) and control (26.61 ± 6.64 mg/dl) groups (P = 0.461). Our results demonstrate a diminished serum osmolarity in manic episode compared with healthy control subjects. This finding supports the hypothesis of a fluid and electrolyte imbalance during acute episodes. Decreased serum osmolarity might be a reflection of a relative haemodilution in mania. However, exploration of the role of fluid and electrolyte homeostasis and mechanisms of related hormones may contribute to a better understanding of the aetiology of bipolar disorder.

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“…It is normally maintained within a narrow range of 275-295 mOsm/L. In previous studies, it was associated with adverse outcomes and mortality in patients with CAD or heart failure (5,6) . However, to the best of our knowledge, the prognostic value of serum osmolarity in patients with STEMI has not been studied yet.…”

Section: Introductionmentioning

confidence: 97%

The Impact of Serum Osmolarity on Contrast-Induced Nephropathy in Patients with ST-Segment Elevation Myocardial Infarction

Kahraman¹,

Zencirkiran²

2019

Kosuyolu Heart Journal

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Introduction:Contrast-induced nephropathy (CIN) is one of the most important causes for increased mortality rates in ST-segment elevation myocardial infarction (STEMI) patients. In our study, we aimed to investigate the impact of serum osmolarity on CIN in patients with STMEI who were undergoing percutaneous coronary intervention. Patients and Methods:A total of 163 consecutive patients with STEMI were enrolled in this study. The patients were divided into two groups; patients without CIN were assigned to group 1 and patients with CIN were assigned to group 2. The baseline clinical, laboratory and demographic features, including the serum osmolarity, were compared for both groups.Results: A total of 144 patients without CIN comprised group 1, while 22 patients with CIN comprised group 2. The serum osmolarity level [289.06 (284.75-292.39), 291.71 (289.69-295.72); p= 0.004] was higher in patients with CIN. Additionally, age (OR: 1.097, CI: 1.033-1.164; p= 0.002) and serum osmolarity (OR:1.117, CI: 1.008-1.238; p= 0.035) were found to be independent predictors of CIN. Conclusion:Higher serum osmolarity is related with CIN in STEMI patients who are undergoing percutaneous coronary intervention. This could cause increased adverse clinical outcomes, even if the underlying coronary artery disease is treated successfully. Giriş: Kontrast ilişkili nefropati (KİN) ST elevasyonlu miyokart infarktüsü (STEMİ) hastalarında artmış mortalitenin en önemli nedenlerinden birisidir. Çalışmamızda perkütan koroner girişim uygulanan STEMİ hastalarında serum ozmolaritesinin KİN üzerine etkisini incelemeyi amaçladık. Hastalar ve Yöntem: STEMİ olan 163 ardışık hasta çalışmaya dahil edildi. Ardından hastalar KİN gelişmeyen grup 1 ve gelişen grup 2 olarak ikiye ayrıldı. Bazal klinik, serum ozmolaritesini içeren laboratuvar ve demografik özellikler her iki grupta karşılaştırıldı. Bulgular: Yüz kırk dört KİN olmayan hasta grup 1, yirmi iki KİN olan hasta grup 2 olarak alındı. Serum ozmolaritesi KİN gelişen hastalarda daha yüskek saptandı [289.06 (284.75-292.39), 291.71 (289.69-295.72); p= 0.004]. Ayrıca yaş (OR: 1.097, CI: 1.033-1.164; p= 0.002) ve serum ozmolaritesi (OR: 1.117, CI: 1.008-1.238; p= 0.035) KİN'in bağımsız öngördürücüleri olarak saptandı. Sonuç: Artmış serum ozmolaritesi perkütan koroner girişim uygulanan STEMİ hastalarında KİN ile ilişkilidir. Bu ilişki koroner arter hastalığı tedavi edilse bile artmış kötü klinik sonlanımlardan sorumlu olabilir. Anahtar Kelimeler: Kontrast nefropatisi, serum ozmolaritesi, ST elevasyonlu miyokart infarktüsü Cite this arcticle as: Kahraman S, Zencirkıran Ağuş H. The impact of serum osmolarity on contrast-induced nephropathy in patients with ST-segment elevation myocardial infarction. Koşuyolu Heart J 2019;22(3):157-61.

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High serum osmolarity at admission determines a worse outcome in patients with heart failure: Is a new target emerging?

Cited by 29 publications

References 20 publications

The predictive value of plasma osmolality for in‐hospital mortality in patients with acute pulmonary embolism

The predictive value of plasma osmolality for in‐hospital mortality in patients with acute pulmonary embolism

Serum osmolarity in male patients with bipolar disorder manic episode

The Impact of Serum Osmolarity on Contrast-Induced Nephropathy in Patients with ST-Segment Elevation Myocardial Infarction

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