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Journal of Clinical Cardiology

ISSN: 2694-5088

Original Research Open Access
Volume 6 | Issue 1 | DOI: https://doi.org/10.33696/cardiology.6.070

Hyponatremia Predicts Adverse Outcomes after Transcatheter Mitral Valve Repair

Olayiwola Olalekan Paul1,*, Emmanuel Daniel2, Birgurman Singh1, Abdulraheem Eniola Hassan1, Busayo Samuel Osineye1, Ali Junaid1, Allan Santos Argueta1, Tioluwani Ojo3, Nirmal J. Kaur4
  • 1Department of Internal Medicine, Saint Peter’s University Hospital, New Jersey, United States
  • 2Department of Internal Medicine, Trinity Health Ann Arbor, Michigan, United States
  • 3Department of Internal Medicine, Suny Upstate Medical Centre, New York, United States
  • 4Columbia University Irving Medical Center, New York, United States
+ Affiliations - Affiliations

Corresponding Author

Olayiwola Olalekan Paul, Lammipaul@gmail.com

Received Date: February 22, 2025

Accepted Date: March 31, 2025

Citation:

Paul OO, Daniel E, Singh B, Hassan AE, Osineye BS, Junaid A, et al. Hyponatremia predicts adverse outcomes after Transcatheter Mitral Valve Repair. J Clin Cardiol. 2025;6(1):48-56.


Copyright: © 2025 Paul OO, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Background: Transcatheter mitral valve repairs have been utilized significantly more over the last decade to treat mitral valve regurgitation. Hyponatremia, the most common electrolyte abnormality in hospitalized patients, adversely impacts patient outcomes. However, the impact of hyponatremia on cardiovascular outcomes among TMVR patients remains to be explored.

Methods: A retrospective cohort study utilizing the TrinetX US network was conducted. Patients aged 18-90 years who underwent TMVR were identified and categorized into two groups: those with and without hyponatremia. Propensity score matching was employed to mitigate potential confounding factors. The primary outcome was 30-day mortality. Secondary outcomes included acute heart failure hospitalization, acute myocardial infarction, cardiogenic shock, acute kidney injury, and cardiac arrest.

Results: Following PSM, the patient population was predominantly white and male, with a mean age of 77.2 in the hyponatremia cohort and 77.1 in the no-hyponatremia cohort. Covariates were well balanced between both groups. Patients with hyponatremia exhibited a significantly increased risk of 30-day mortality compared to those without (Hazard Ratio [HR] 2.646, 95% Confidence Interval [CI] 1.973-3.548, p<0.001). Additionally, patients with hyponatremia demonstrated a significantly increased risk of acute heart failure hospitalization (HR 1.116, 95% CI 1.032-1.208, p=0.014), acute myocardial infarction (HR 1.54, 95% CI 1.114-2.128, p=0.008), cardiogenic shock (HR 2.1, 95% CI 1.55-2.845, p<0.001), acute kidney injury (HR 2.141, 95% CI 1.781-2.574, p<0.001), and cardiac arrest (HR 1.823, 95% CI 1.1055-3.149, p=0.021). No significant difference was observed in the risk of stroke or hypertensive emergencies between the groups.

Conclusions: Hyponatremia is linked to heightened adverse cardiovascular outcomes in patients undergoing TMVR, including increased 30-day mortality. These findings emphasize the critical importance of vigilant electrolyte monitoring and proactive management of hyponatremia in this patient population to improve post-procedural outcomes.

Keywords

Arrhythmia, Cardiac surgery, Cardiovascular risk reduction, Congestive heart failure, Hyponatremia, Interventional cardiology, Transcatheter, Transcatheter mitral valve repair

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