Abstract：
BACKGROUND: For decades standard teaching recommended salt intake (sodium) reduction in patients suffering from heart failure. Neurohumoral activation with subsequent fluid retention provided a solid rationale for this long-standing recommendation. Until recently no large randomized clinical trial of sodium restriction was available, while some observational studies and metanalyses even suggested a worse outcome with strict sodium restriction in patients with heart failure.
METHODS: In this narrative review we aimed to extricate from the literature whether strict sodium restriction is beneficial in patients with heart failure. We searched PubMed indexed articles between 2000 and 2023 for these terms: heart failure, salt, sodium, fluid intake.
RESULTS: Most randomized trials were small and showed a wide heterogeneity of interventions. A single large, randomized clinical trial was stopped early due to futility. Overall, there is no evidence that severe sodium restriction reduces the incidence of mortality and hospitalization in patients with heart failure. Quality of life and functional class may improve slightly with sodium restriction.
CONCLUSIONS: Morbidity and mortality are not reduced with sodium restriction in patients with heart failure, although some symptomatic improvement may be expected.
METHODS: In this narrative review we aimed to extricate from the literature whether strict sodium restriction is beneficial in patients with heart failure. We searched PubMed indexed articles between 2000 and 2023 for these terms: heart failure, salt, sodium, fluid intake.
RESULTS: Most randomized trials were small and showed a wide heterogeneity of interventions. A single large, randomized clinical trial was stopped early due to futility. Overall, there is no evidence that severe sodium restriction reduces the incidence of mortality and hospitalization in patients with heart failure. Quality of life and functional class may improve slightly with sodium restriction.
CONCLUSIONS: Morbidity and mortality are not reduced with sodium restriction in patients with heart failure, although some symptomatic improvement may be expected.
摘要：
背景：几十年来，标准教学建议减少患有心力衰竭的患者的盐摄入量（钠）。神经体液激活和随后的液体潴留为这一长期建议提供了坚实的理由。直到最近还没有关于限钠的大型随机临床试验，而一些观察性研究和荟萃分析甚至提示心力衰竭患者严格限钠的结局更差。
方法：在这篇叙述性综述中，我们旨在从文献中说明严格限钠对心力衰竭患者是否有益。我们搜索了PubMed在2000年至2023年之间的索引文章，寻找以下术语：心力衰竭，盐,钠,液体摄入量。
结果：大多数随机试验规模较小，并显示出干预措施的广泛异质性。一个大的，随机临床试验由于无效而提前停止.总的来说,没有证据表明严重限钠可降低心力衰竭患者的死亡率和住院率.生活质量和功能等级可能在钠限制下略有改善。
结论：心力衰竭患者的钠限制并没有降低发病率和死亡率，尽管可能会有一些症状改善。
方法：在这篇叙述性综述中，我们旨在从文献中说明严格限钠对心力衰竭患者是否有益。我们搜索了PubMed在2000年至2023年之间的索引文章，寻找以下术语：心力衰竭，盐,钠,液体摄入量。
结果：大多数随机试验规模较小，并显示出干预措施的广泛异质性。一个大的，随机临床试验由于无效而提前停止.总的来说,没有证据表明严重限钠可降低心力衰竭患者的死亡率和住院率.生活质量和功能等级可能在钠限制下略有改善。
结论：心力衰竭患者的钠限制并没有降低发病率和死亡率，尽管可能会有一些症状改善。
