Related Experiment Video
Updated: Aug 17, 2025
Cutoff Value of Phase Angle by Bioelectrical Impedance Analysis at Admission as a Prognostic Factor in Patients with Acute Heart Failure
Published on: June 10, 2025
Associations between serum electrolyte and short-term outcomes in patients with acute decompensated heart failure
Kai Zhao1, Qun Zheng2, Jiang Zhou3
1Department of Cardiology, The Second Hospital of Hebei Medical University, Shijiazhuang, China.
Insights
Serum electrolyte imbalances, including low potassium, sodium, and chloride, are linked to worse outcomes in acute decompensated heart failure (ADHF) patients. The number of electrolyte abnormalities significantly predicts adverse short-term prognosis in ADHF.
Area of Science:
- Cardiology
- Internal Medicine
- Clinical Research
Background:
- Acute decompensated heart failure (ADHF) poses significant short-term prognosis challenges.
- Comprehensive studies on serum electrolyte associations with ADHF prognosis are limited, particularly in Chinese populations.
Purpose of the Study:
- To investigate the relationship between serum electrolytes (potassium, sodium, chloride, and total calcium) and adverse short-term outcomes in Chinese ADHF patients.
- To determine if the number of electrolyte abnormalities predicts prognosis in ADHF.
Main Methods:
- A cohort of 5166 ADHF patients was analyzed.
- Logistic regression models assessed associations between serum electrolytes and a composite outcome of all-cause mortality or 30-day HF readmission.
- Analysis included individual electrolytes and the count of electrolyte abnormalities.
Main Results:
- Deviations in serum potassium from the 3.50-4.00 mmol/L range were associated with increased risk.
- Lower serum sodium levels (<140 mmol/L) and hypochloremia (<95 mmol/L) were linked to higher composite outcome risks.
- A positive correlation was observed between the number of electrolyte abnormalities and adverse prognosis (p for trend < 0.001).
Conclusions:
- Serum potassium levels outside the 3.50-4.00 mmol/L range, low sodium, and hypochloremia are associated with poorer short-term ADHF prognosis.
- The number of electrolyte abnormalities is a significant predictor of adverse outcomes in ADHF patients.
- Targeting electrolyte balance may improve short-term outcomes in ADHF.
Introduction:
There is a dearth of comprehensive studies on the association between serum electrolyte and adverse short-term prognosis of Chinese patients with acute decompensated heart failure (ADHF).
Patients And Methods:
A total of 5166 patients with ADHF were divided into four serum electrolyte-related study populations (potassium (n = 5145), sodium (n = 5135), chloride (n = 4966), serum total calcium (STC) (n = 4143)) under corresponding exclusions. Different logistic regression models were utilized to gauge the association between these electrolytes or the number of electrolyte abnormalities and the risk of a composite of all-cause mortality or 30-day heart failure (HF) readmission.
Results:
In multivariable adjusted analysis, patients with potassium below 3.5 mmol/L (odds ratios (ORs) 1.45; 95% confidence interval (CI):1.07-1.95), 4.01-4.50 mmol/L (OR: 1.29, CI: 1.02-1.62), 4.51-5.00 mmol/L (OR: 1.43, CI: 1.08-1.90) and above 5.00 mmol/L (OR: 1.74, CI: 1.21-2.51) had an increased risk of outcome when compared with potassium at 3.50-4.00 mmol/L. Sodium levels were inversely related to the risk of a composite outcome (<130 mmol/L: OR: 2.73 (95% CI, 1.81-4.12); 130-134 mmol/L: OR, 1.97 (CI, 1.45-2.68); 135-140 mmol/L: OR, 1.45 (CI, 1.17-1.81); p for trend < 0.001) in comparison with sodium at 141-145 mmol/L. Chloride < 95 mmol/L corresponded to a higher risk of a composite outcome with an OR of 1.65 (95% CI, 1.16-2.37) in contrast to chloride levels at 101-105 mmol/L. In addition, the adjusted ORs (95% CI) for a composite outcome comparing the STC < 2.00 and 2.00-2.24 vs. 2.25-2.58 mmol/L were 0.98 (0.69-1.43) and 1.13 (0.89-1.44), respectively. Besides that, the number of electrolyte abnormalities was positively related to the risk of a composite outcome (N = 1, OR 1.40, 95% CI: 1.13-1.73; N = 2, OR 2.51, 95% CI: 1.85-3.42; N = 3, OR 2.47, 95% CI: 1.45-4.19; p for trend < 0.001) in comparison with N = 0.
Conclusions:
A deviation of potassium levels from 3.50 to 4.00 mmol/L, lower sodium levels and hypochloremia were associated with poorer short-term prognosis of ADHF. Furthermore, the number of electrolyte abnormalities positively correlated with adverse short-term prognosis of patients with ADHF. Key MessagesADHF patients with baseline serum potassium at first half part of normal range (3.50-4.00 mmol/L) may herald the lowest risk of recent cardiovascular events.Serum sodium and chloride levels exhibit discrepancies in terms of risk of short-term adverse events of ADHF patients.The number of electrolyte abnormalities is a significant predictor of poor short-term prognosis in patients with ADHF.
Clinical Trial Registration Url:
http://www.chictr.org.cn/showproj.aspx?proj=23139. Unique identifier: ChiCTR-POC-17014020.
More Related Videos
10:21Evaluation of Hydration Status by Bioelectrical Impedance Vector Analysis in Patients with Ischemic Heart Disease Undergoing Exercise Stress Test
Published on: September 22, 2023
08:28Methods for ECG Evaluation of Indicators of Cardiac Risk, and Susceptibility to Aconitine-induced Arrhythmias in Rats Following Status Epilepticus
Published on: April 5, 2011
Related Concept Videos
01:22Heart Failure VI: Adjunct Therapies
01:22Acute Kidney Injury VI: Nursing Management
01:22Heart Failure Drugs: Diuretics
01:29Heart Failure II: Pathophysiology
01:30Heart Failure V: Medical Management
01:20Acute Kidney Injury V: Interprofessional Care