Correlation of thirst with ejection fraction and plasma sodium level in elderly with chronic heart failure

Abstract

ABSTRAK
Latar Belakang: Haus merupakan simptom yang umum dan mengganggu bagi pasien gagal jantung.
Banyak pasien gagal jantung usia lanjut mengeluh rasa haus berlebihan. Perjalanan alamiah gagal jantung,
terapi farmakologi dan non farmakologi dapat meningkatkan rasa haus. Cardiac output yang rendah dan
peningkatan aktivasi sistem neurohormonal seperti sistem renin-angiotensin aldosteron akan merangsang
pusat haus di hipotalamus. Hubungan antara rasa haus dengan fraksi ejeksi dan kadar natrium plasma pada
pasien gagal jantung kronis usia lanjut belum diketahui.
Tujuan: Tujuan dari penelitian ini adalah untuk mengetahui hubungan antara derajat rasa haus dengan
fraksi ejeksi dan kadar natrium plasma pada gagal jantung kronis usia lanjut.
Metode: Penelitian menggunakan metode potong lintang, dilakukan di Bagian Penyakit Dalam dan Bagian
Kardiologi RSUP Dr. Sardjito Yogyakarta. Subyek penelitian adalah pasien usia lanjut penderita gagal jantung
kelas fungsional III-IV sesuai dengan kriteria NYHA, usia ≥60 tahun. Pengukuran rasa haus dilakukan
dengan menggunakan skor VAS. Pemeriksaan fraksi ejeksi dilakukan dengan ekokardiografi . Karakteristik
subyek penelitian disajikan dalam bentuk rerata dan simpangan baku. Hubungan antara derajat rasa haus
dengan fraksi ejeksi dan kadar natrim plasma dianalisis dengan menggunakan uji korelasi Pearson. Nilai p
<0.05 dianggap signifi kan.
Hasil: Didapatkan 30 subyek sebanyak 63.3% laki-laki dengan median usia 69.5 tahun. Diperoleh rerata rasa
haus 63.67±17.5 mm dan rerata fraksi ejeksi sebesar 41.93±15.5%. Rerata hasil pemeriksaan kadar natrium
adalah 139.7±4.1 mmol/l sedangkan rerata osmolalitas plasma 296.4±10.1 mOsm/kg.
Kesimpulan: Pada uji korelasi Pearson didapatkan korelasi antara rasa haus dengan fraksi ejeksi adalah
korelasi negatif lemah namun tidak signifi kan secara statistic (r=-0.314, p=0.091). Tidak didapatkan korelasi
antara rasa haus dengan kadar natrium plasma (r=-0.04 p=0.833).
Kata kunci: usia lanjut, rasa haus, gagal jantung kronis, fraksi ejeksi, natrium plasma
ABSTRACT
Background: Thirst is a common symptom that disturbs patient with heart failure. Many elderly patients with
heart failure get severe thirst. Natural history of heart failure, pharmacological and non-pharmacological therapies
could increase the thirst level. Low cardiac output and activation of neuro-hormonal system e.g. renin angiotensinaldosterone
system, would stimulate the thirst center in hypothalamus. Correlations of thirst with ejection fraction
and plasma sodium level in elderly with chronic heart failure have not been known yet.
Aims: The aims of this study are to investigate the correlations of thirst with ejection fraction and plasma
sodium level in elderly with chronic heart failure. Cross sectional design has been conducted on elderly patients
(age of ≥60 years) with heart failure of functional class of III-IV (based on NYHA criteria) in Department
of Internal Medicine and Department of Cardiology, Dr. Sardjito General Hospital, Yogyakarta.Method: Measurement of thirst was done using VAS score, while the investigation of ejection fraction was
performed using echocardiography. Characteristics of subjects were presented in the average and standard
deviation values. Correlations between thirst with ejection fraction and plasma sodium level were analyzed
by using Pearson correlation test with p < 0.05 considered to be signifi cant.
Result: There were 30 subjects, 63.3% male, median of age of 69.5 years. The average of thirst value was
63.67} 17.5 mm and the ejection fraction was 41.93} 15.5%. The averages of plasma sodium level and
plasma osmolality were respectively 139.7} 4.1 mmole/l and 296.4} 10.1 mOsm/kg.
Conclusion: Pearson correlation test has revealed a weak negative correlation of thirst and ejection fraction
(r= -0.314, p=0.091). On the other hand, there was no correlation between thirst and plasma sodium level
(r=-0.04 p=0.833).
Keywords: thirst, elderly, chronic heart failure, ejection fraction, plasma sodium level