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Persistent Hypochloremia Is Associated with Adverse Prognosis in Patients Repeatedly Hospitalized for Heart Failure

Background: Hypochloremia reflects neuro-hormonal activation in patients with heart failure (HF). However, the prognostic impact of persistent hypochloremia in those patients remains unclear. Methods: We collected the data of patients who were hospitalized for HF at least twice between 2010 and 2021...

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Detalles Bibliográficos
Autores principales: Nozaki, Yuji, Yoshihisa, Akiomi, Sato, Yu, Ohara, Himika, Sugawara, Yukiko, Abe, Satoshi, Misaka, Tomofumi, Sato, Takamasa, Oikawa, Masayoshi, Kobayashi, Atsushi, Yamaki, Takayoshi, Nakazato, Kazuhiko, Takeishi, Yasuchika
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9962161/
https://www.ncbi.nlm.nih.gov/pubmed/36835793
http://dx.doi.org/10.3390/jcm12041257
Descripción
Sumario:Background: Hypochloremia reflects neuro-hormonal activation in patients with heart failure (HF). However, the prognostic impact of persistent hypochloremia in those patients remains unclear. Methods: We collected the data of patients who were hospitalized for HF at least twice between 2010 and 2021 (n = 348). Dialysis patients (n = 26) were excluded. The patients were divided into four groups based on the absence/presence of hypochloremia (<98 mmol/L) at discharge from their first and second hospitalizations: Group A (patients without hypochloremia at their first and second hospitalizations, n = 243); Group B (those with hypochloremia at their first hospitalization and without hypochloremia at their second hospitalization, n = 29); Group C (those without hypochloremia at their first hospitalization and with hypochloremia at their second hospitalization, n = 34); and Group D (those with hypochloremia at their first and second hospitalizations, n = 16). Results: a Kaplan–Meier analysis revealed that all-cause mortality and cardiac mortality were the highest in Group D compared to the other groups. A multivariable Cox proportional hazard analysis revealed that persistent hypochloremia was independently associated with both all-cause death (hazard ratio 3.490, p < 0.001) and cardiac death (hazard ratio 3.919, p < 0.001). Conclusions: In patients with HF, prolonged hypochloremia over two hospitalizations is associated with an adverse prognosis.