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Published on: June 10, 2025
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Persistent Hypochloremia Is Associated with Adverse Prognosis in Patients Repeatedly Hospitalized for Heart Failure
Yuji Nozaki1, Akiomi Yoshihisa1,2, Yu Sato1
1Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima 960-1247, Japan.
Journal of Clinical Medicine
|February 25, 2023
Summary
Persistent hypochloremia in heart failure (HF) patients indicates poor prognosis. Patients with hypochloremia during two hospitalizations faced higher mortality risks, highlighting its significance.
Area of Science:
- Cardiology
- Nephrology
- Internal Medicine
Background:
- Hypochloremia (low blood chloride) is linked to neuro-hormonal activation in heart failure (HF).
- The prognostic value of persistent hypochloremia in HF patients is not well understood.
Purpose of the Study:
- To investigate the prognostic impact of persistent hypochloremia in patients hospitalized for heart failure.
Main Methods:
- Retrospective analysis of 348 heart failure patients hospitalized twice between 2010-2021.
- Exclusion of dialysis patients.
- Classification into four groups based on hypochloremia status (<98 mmol/L) at discharge from first and second hospitalizations.
Main Results:
- Kaplan-Meier analysis showed highest all-cause and cardiac mortality in patients with hypochloremia at both hospitalizations (Group D).
- Multivariable Cox analysis revealed persistent hypochloremia independently predicted all-cause death (HR 3.490) and cardiac death (HR 3.919).
Conclusions:
- Prolonged hypochloremia across two hospitalizations is associated with adverse outcomes in heart failure patients.
- Persistent hypochloremia serves as a significant predictor of mortality in heart failure.
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