Importance of Abnormal Chloride Homeostasis in Stable Chronic Heart Failure.
نویسندگان
چکیده
BACKGROUND The aim of this analysis was to determine the long-term prognostic value of lower serum chloride in patients with stable chronic heart failure. Electrolyte abnormalities are prevalent in patients with chronic heart failure. Little is known regarding the prognostic implications of lower serum chloride. METHODS AND RESULTS Serum chloride was measured in 1673 consecutively consented stable patients with a history of heart failure undergoing elective diagnostic coronary angiography. All patients were followed for 5-year all-cause mortality, and survival models were adjusted for variables that confounded the chloride-risk relationship. The average chloride level was 102 ± 4 mEq/L. Over 6772 person-years of follow-up, there were 547 deaths. Lower chloride (per standard deviation decrease) was associated with a higher adjusted risk of mortality (hazard ratio 1.29, 95% confidence interval 1.12-1.49; P < 0.001). Chloride levels net-reclassified risk in 10.4% (P = 0.03) when added to a multivariable model (with a resultant C-statistic of 0.70), in which sodium levels were not prognostic (P = 0.30). In comparison to those with above first quartile chloride (≥ 101 mEq/L) and sodium (≥ 138 meq/L), subjects with first quartile chloride had a higher adjusted mortality risk, whether they had first quartile sodium (hazard ratio 1.35, 95% confidence interval 1.08-1.69; P = 0.008) or higher (hazard ratio 1.43, 95% confidence interval 1.12-1.85; P = 0.005). However, subjects with first quartile sodium but above first quartile chloride had no association with mortality (P = 0.67). CONCLUSIONS Lower serum chloride levels are independently and incrementally associated with increased mortality risk in patients with chronic heart failure. A better understanding of the biological role of serum chloride is warranted.
منابع مشابه
Family-Centered Education and Self-care Behaviors of Patients With Chronic Heart Failure
Background: As for high prevalence and incidence of heart failure, it can impose huge health, economic, and social burden on society. Education and self-care are important aspects of management in patients with heart failure, which can control the disease complications. This study aimed to investigate the effect of family-centered education approach on self-care behaviors of the patients wi...
متن کاملMechanisms Governing the Postural Response and Baroreceptor Abnormalities in Chronic Congestive Heart Failure: Effects of Acute
We assessed the hemodynamic and hormonal response to tilt and the baroreceptor response in 12 patients in sinus rhythm with severe chronic congestive heart failure. We also assessed the response to acute (n = 12) and chronic (n = 8) converting-enzyme inhibition with captopril. The control tilt was characterized by high cardiac filling pressures, absence of significant peripheral pooling and app...
متن کاملMechanisms governing the postural response and baroreceptor abnormalities in chronic congestive heart failure: effects of acute and long-term converting-enzyme inhibition.
We assessed the hemodynamic and hormonal response to tilt and the baroreceptor response in 12 patients in sinus rhythm with severe chronic congestive heart failure. We also assessed the response to acute (n = 12) and chronic (n = 8) converting-enzyme inhibition with captopril. The control tilt was characterized by high cardiac filling pressures, absence of significant peripheral pooling and app...
متن کاملEndurance training induces fiber type-specific revascularization in hindlimb skeletal muscles of rats with chronic heart failure
Objective(s): Previous studies showed that skeletal muscle microcirculation was reduced in chronic heart failure. The aim of this study was to investigate the effects of endurance training on capillary and arteriolar density of fast and slow twitch muscles in rats with chronic heart failure. Materials and Methods: Four weeks after surgeries (left anterior descending (LAD) artery occlusion), chr...
متن کاملBackground & Objective : Heart failure is a clinical syndrome and increases in rate by aging. Because changes in ECG and electrolytes are variable, specific and sometimes independent to the disease with different methods to be diagnosed, in this study we tried to find a way to diagnose them. Materials & Methods: This is a retrospective descriptive-analytic study. Data was collected from dec...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- Circulation. Heart failure
دوره 9 1 شماره
صفحات -
تاریخ انتشار 2016