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Lactate in Heart Failure
Piotr Gajewski1, Michał Maksymilian Wilk2, Krzysztof Aleksandrowicz1,3
1Institute of Heart Diseases, Wroclaw Medical University, 50-556 Wrocław, Poland.
International Journal of Molecular Sciences
|July 29, 2025
Summary
Lactate is a key indicator in heart failure (HF), signaling poor blood flow and predicting outcomes. Understanding lactate
Area of Science:
- Cardiology
- Biochemistry
- Metabolic Research
Background:
- Lactate is traditionally viewed as a byproduct of anaerobic metabolism.
- Its role in heart failure (HF) pathophysiology is complex and not fully understood.
- Lactate may act as both a marker and an active metabolic substrate.
Purpose of the Study:
- To review the diagnostic and prognostic significance of lactate in acute and chronic heart failure.
- To explore lactate's dual role as a marker of hypoperfusion and an active metabolic substrate.
- To discuss lactate's potential in risk stratification and guiding therapy for HF patients.
Main Methods:
- Narrative review of existing literature.
- Analysis of lactate's role in acute decompensated heart failure.
- Examination of lactate dynamics during exercise in chronic heart failure, including HFpEF.
Main Results:
- Elevated lactate levels in acute HF indicate circulatory insufficiency and predict adverse events.
- Lactate dynamics during exercise in chronic HF reflect metabolic inefficiency and functional capacity.
- Lactate's role varies between different HF phenotypes and clinical settings.
Conclusions:
- Lactate possesses a multifaceted role in heart failure, extending beyond a simple metabolic byproduct.
- Its measurement offers valuable insights for diagnosing severity, predicting prognosis, and guiding treatment strategies in HF.
- Further research into lactate's metabolic functions could enhance risk stratification and therapeutic approaches in heart failure management.
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