@article{2987552,
    title = "Safety and efficacy of salt substitution with a low sodium-potassium enriched dietary salt in patients with heart failure with reduced ejection fraction: A pilot study",
    author = "Bistola, V. and Arfaras-Melainis, A. and Trogkanis, E. and Bakosis, G. and Polyzogopoulou, E. and Karavidas, I.-N. and Ikonomidis, I. and Parissis, J. and Karavidas, A.",
    journal = "Clinical Nutrition ESPEN",
    year = "2020",
    volume = "35",
    pages = "90-94",
    publisher = "Elsevier Ireland Ltd",
    issn = "2405-4577",
    doi = "10.1016/j.clnesp.2019.11.004",
    keywords = "aged;  Article;  clinical article;  controlled study;  creatinine blood level;  diastolic blood pressure;  diet restriction;  dietary compliance;  estimated glomerular filtration rate;  exercise;  female;  heart failure with reduced ejection fraction;  heart left ventricle ejection fraction;  heart rate;  human;  male;  New York Heart Association class;  nuclear magnetic resonance imaging;  pilot study;  potassium blood level;  prospective study;  quality of life;  salt intake;  sodium blood level;  systolic blood pressure;  administration and dosage;  blood;  controlled clinical trial (topic);  glomerulus filtration rate;  heart failure;  middle aged;  potassium intake;  salt intake;  sodium restriction, potassium;  sodium, Aged;  Diet, Sodium-Restricted;  Exercise;  Female;  Glomerular Filtration Rate;  Heart Failure;  Humans;  Male;  Middle Aged;  Non-Randomized Controlled Trials as Topic;  Pilot Projects;  Potassium;  Potassium, Dietary;  Prospective Studies;  Sodium;  Sodium Chloride, Dietary",
    abstract = "Background and aims: Increased sodium intake is associated with increased risk of decompensation in patients with heart failure. This non-randomized, open-label, controlled study aimed to examine the feasibility, preliminary safety and efficacy of a low sodium-potassium enriched salt substitute compared to regular table salt in patients with heart failure with reduced ejection fraction (HFREF). Methods: Fifty patients (68% male, NYHA I/II/III 6%/68%/26%, mean age 70 ± 9 years, LVEF 31 ± 5%, median BNP 112 pg/ml) were included. Of these, 30 patients received the salt substitute (maximum consumption of 2 g daily), who were prospectively compared to a control group of 20 age/sex/NYHA class-matched HFREF patients who consumed regular salt (maximum consumption of 2 g daily). Consumption of regular salt was prohibited in the salt substitution group. All patients were followed for 12 weeks. Results: Patient groups did not differ by sex, age, LVEF, NYHA class, 6MWD, and BNP at baseline. In primary safety analysis, no significant differences were detected between groups regarding SBP (p = 0.052), DBP (p = 0.159), HR (p = 0.246), serum potassium (p = 0.579), serum sodium (p = 0.125), and eGFR (p = 0.710) throughout the 12 weeks. Secondary efficacy analysis revealed a statistically significant difference in 6MWD at 12 weeks between the salt substitute and regular salt groups after adjustment for baseline 6MWD (mean difference±SEM, 4.7 ± 2.1 m, F = 4.92, p = 0.031). Conclusions: In this pilot study, a low sodium-potassium enriched salt substitute was found to be safe compared to regular salt in HFREF patients, while it resulted in a small albeit significant improvement in exercise capacity, possibly justifying further investigation with randomized clinical studies. © 2019 European Society for Clinical Nutrition and Metabolism"
}