Persistent hypochloremia associated with worse heart failure outcomes

Written By : Jacinthlyn Sylvia |Medically Reviewed By : Dr. Kamal Kant Kohli Published On 2023-01-11T09:45:24+05:30 | Updated On 11 Jan 2023 1:54 PM IST

A new study by Shinichi Kurashima and team shows that while resolved hypochloremia and normochloremia showed a similar prognosis, persistent hypochloremia was linked to worse clinical outcomes. The findings of the study were published in the International Journal of Cardiology.

A potential risk for poor consequences in patients with acute heart failure is hypochloremia. Serum chloride levels fluctuate throughout decongestion therapy, however it is unknown how these variations affect prognosis. The study aimed to investigate the relationship between serum chloride levels and decongestion.

For the study, according to their admission and discharge serum chloride levels, a total of 2798 patients with AHF were retrospectively studied and divided into four groups: (1) normochloremia (n=2,192, 78%); (2) treatment-associated hypochloremia, defined as admission normochloremia with a subsequent decrease (98 mEq/L) during hospitalization (n=335, 12%); (3) resolved hypochloremia, defined as admission hypochloremia that disappeared at discharge (n=128, 5%); All-cause mortality was the primary outcome, and cardiovascular death and a composite of cardiovascular death and rehospitalization for heart failure after discharge were the secondary outcomes.

The key findings of the study were:

1. 1584 (57%) of the patients were men, with a mean age of 76 12 years.

2. There was a 46 16% average left ventricular ejection fraction.

3. Persistent hypochloremia was linked to an increased risk of all-cause death, cardiovascular death, and a composite of cardiovascular death and heart failure rehospitalization over the course of a median follow-up period of 365 days (adjusted hazard ratio [95% confidence interval]: 2.27 [1.53-3.37, p 0.001), 2.38 [1.46-3.87, p 0.001, and 1.47 [1.06-2.06, p

4. Patients with resolved hypochloremia and those with normochloremia, however, had comparable results.

Reference:

Kurashima, S., Kitai, T., Matsue, Y., Nogi, K., Kagiyama, N., Oishi, S., Akiyama, E., Suzuki, S., Yamamoto, M., Kida, K., Okumura, T., Nogi, M., Ishihara, S., Ueda, T., Kawakami, R., Furukawa, Y., Saito, Y., & Izumi, C. (2022). Trajectory of serum chloride levels during decongestive therapy in acute heart failure. In International Journal of Cardiology. Elsevier BV. https://doi.org/10.1016/j.ijcard.2022.12.041

International Journal of Cardiologyleft ventricular ejection fractionSerum chloride

Source : International Journal of Cardiology

Jacinthlyn Sylvia

Neuroscience Masters graduate

Jacinthlyn Sylvia, a Neuroscience Master's graduate from Chennai has worked extensively in deciphering the neurobiology of cognition and motor control in aging. She also has spread-out exposure to Neurosurgery from her Bachelor’s. She is currently involved in active Neuro-Oncology research. She is an upcoming neuroscientist with a fiery passion for writing. Her news cover at Medical Dialogues feature recent discoveries and updates from the healthcare and biomedical research fields. She can be reached at editorial@medicaldialogues.in

Dr. Kamal Kant Kohli

Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751