Changes in Salt Taste Sensitivity and Heart Failure Readmissions

Abstract

Introduction Increased salt taste sensitivity may be associated with improved heart failure (HF) outcomes following HF hospitalization. Hypothesis An increase in salt taste sensitivity from admission to 12-weeks follow-up will be associated with fewer days rehospitalized and higher Kansas City Cardiomyopathy Questionnaire clinical summary scores (KCCQ-CSS) compared to subjects with no increase in salt taste sensitivity. Methods We examined salt taste sensitivity in the GOURMET-HF trial, a pilot study investigating the effects of home-delivered meals in post-discharge patients with HF. Salt taste sensitivity was assessed by measuring changes in salt taste recognition threshold on enrollment, discharge, 1, 4, and 12-weeks follow-up using Salsave test strips standardized with 0.6-1.6 mg/cm2 NaCl solution. Subjects were divided into two groups: increase or no increase salt taste sensitivity. Baseline characteristics between groups and outcomes were compared using two-sample t-tests, chi-squared tests, and log-transformed t-tests for parameters that were not normally distributed. Results Baseline characteristics did not differ for subjects with an increase in salt taste sensitivity over 12-weeks (n=25) compared to those without an increase in salt taste sensitivity (n=24); they were elderly (71 vs. 69 years) and predominately male (76 vs. 75%). There was a high representation of black (36 vs. 29%) and Hispanic (28 vs. 42%) subjects. Baseline KCCQ-CSS (45.84 [21.74] vs. 44.31 [17.70]) were similar. The enrollment salt taste recognition threshold was higher (1.19 [0.39]) vs. 0.76 [0.28] mg/cm2, p=0.001) and the 12-week threshold was lower (0.71 [0.16] vs. 0.86 [0.32] mg/cm2, p=0.042) in the group with increased salt taste sensitivity. The total number 12-week hospital days was 60 vs. 121 days, with an average number of hospital days of 5.45 [3.88] vs. 11.00 [6.74] (p=0.028) among those hospitalized in the groups with an increase vs. no increase in salt taste sensitivity, respectively (Figure 1). KCCQ-CSS at 12-weeks trended higher in the group with an increase in salt taste sensitivity: (64.24 [23.06] vs. 56.25 [24.80], p=0.195). Conclusions Changes in salt taste sensitivity occurred in some but not all subjects in a 12-week period following hospitalization for HF. Subjects with increased salt taste sensitivity over this time period were rehospitalized for fewer days. Improved salt taste sensitivity may represent a novel prognostic factor in post-discharge patients with HF.