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Prognostic Significance of Hypochloremia Among Hospitalized Patients With Heart Failure and Preserved and Reduced Ejection Fractions

Author : N. G. Liman, B. B. Siswanto
Upload Date : 19-04-2018

Background: Hypochloremia in heart failure (HF) is an established predictor of adverse outcomes in hospitalized patients with reduced ejection fraction (EF). However, there is a paucity of data in hospitalized patients with HF with preserved ejection fraction (HFpEF).

Methods and Results: We examined the prevalence and short-term outcomes of hypochloremia (serum chloride <98 mEq/L) in hospitalized HFpEF and HF with reduced EF (HFrEF). The cohort consisted of 86 patients with HFrEF and 56 patients with HFpEF with a six month follow-up. Hypochloremia was present in 61.6% and 33.9% patients in HFrEF and HFpEF, respectively. Hypochloremia was associated with younger age, atrial fibrillation, severe valvular heart disease, worsening kidney function, and sodium level. In survival analysis, hypochloremia remained a significant predictor of all-cause rehospitalization in both HFrEF (p <0.01) and HFpEF (p <0.01) but not a significant predictor of all-cause mortality in both HFrEF (p= 0.56) and HFpEF  p= 0.83).

Conclusion: Hypochloremia is prevalent at a frequency of over 30% in hospitalized patients with HFpEF and HFrEF. Hypochloremia is a strong prognostic marker of rehospitalization across the spectrum of patients with HFpEF and HFrEF. In contrast, it is neither a predictor of six-month mortality in patients with HFrEF nor in patients with HFpEF.

KEYWORDS : heart failure, ejection fraction, hypochloremia, mortality, rehospitalization


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