Background:Many heart failure (HF) guidelines recommend sodium restriction for patients with HF, but the outcome of sodium restriction counseling (SRC) for HF patients is still unknown. We wanted to clarify whether SRC reduces cardiac events in patients with HF.

Methods and Results:Overall, 800 patients (77±12 years) who were hospitalized for HF were enrolled. During HF hospitalization, patients received SRC; patients were required to have a salt intake of <6 g/day. After discharge, death or HF rehospitalization events were investigated. During a mean follow-up of 319±252 days, 83 patients died, and 153 patients were rehospitalized for HF. SRC significantly decreased all-cause death (odds ratio, 0.42; 95% confidence interval [CI], 0.23–0.76; P<0.01), especially cardiac death of hospitalized HF patients after discharge. In the multivariate analysis adjusted for age, sex, SRC, body mass index, hypertension, dyslipidemia, β-blockers, and mineralocorticoid receptor antagonist intake, cardiac rehabilitation, and the type of HF, SRC remained a significant predictor of death. Kaplan-Meier analysis showed that SRC significantly reduced deaths and the combined outcome of HF rehospitalization and death. In patients with reduced left ventricular ejection fraction, SRC significantly decreased the mortality rate (odds ratio, 0.27; 95% CI, 0.10–0.71; P<0.01).

Conclusions:SRC reduced the mortality rate after discharge of hospitalized HF patients.

背景：许多心力衰竭 (HF) 指南建议对 HF 患者进行钠限制，但对 HF 患者进行钠限制咨询 (SRC) 的结果仍然未知。我们想澄清 SRC 是否可以减少 HF 患者的心脏事件。

方法和结果：总体而言，纳入了 800 名因心衰住院的患者（77±12 岁）。在 HF 住院期间，患者接受了 SRC；要求患者的盐摄入量<6克/天。出院后，对死亡或心衰再住院事件进行了调查。在平均 319±252 天的随访中，83 名患者死亡，153 名患者因 HF 再次住院。SRC 显着降低全因死亡（优势比，0.42；95% 置信区间 [CI]，0.23-0.76；P<0.01），尤其是住院 HF 患者出院后的心源性死亡。在对年龄、性别、SRC、体重指数、高血压、血脂异常、β受体阻滞剂和盐皮质激素受体拮抗剂摄入量、心脏康复和心衰类型进行调整的多变量分析中，SRC仍然是死亡的重要预测因素。Kaplan-Meier 分析表明，SRC 显着降低了死亡率以及 HF 再住院和死亡的综合结果。在左心室射血分数降低的患者中，SRC 显着降低了死亡率（优势比，0.27；95% CI，0.10-0.71；P<0.01）。

结论： SRC降低了住院心衰患者出院后的死亡率。