Abstract 17491: Prognostic Value of Serial Change of Serum Chloride Level During Hospitalization in Patients With Acute Decompensated Heart Failure
Background: Although hyponatremia had been reported to be a strong predictor of morbidity and mortality in patients (pts) with acute decompensated heart failure (ADHF), recent studies have shown that hypochloremia is independently associated with poor prognosis in ADHF pts. However, little is known about the prognostic value of serial change in serum chloride level during hospitalization in ADHF pts.
Method and Results: We prospectively enrolled 124 ADHF patients discharged with survival (LVEF: 48±15%). We performed venous blood sampling at admission and discharge. All study pts were divided into 4 groups according to serum chloride level at admission and discharge;(i)persistent hypochloremia (n=8) with hypochloremia (<98.0mEq/L) both at admission and before discharge, (ii)progressive hypochloremia (n=32) with the development of hypochloremia after admission, (iii)improved hypochloremia (n=6) with hypochloremia only at admission but not at discharge, and (iv) no hypochloremia during hospitalization (n=78). During a mean follow up period of 1.9 ± 0.8 years, 17 of 122 pts had pump failure death (PFD). Adjusted in the model with each comorbidity such as serum sodium level, serum creatinine and blood urea nitrogen, both serum chloride level at admission and discharge were still significantly associated with PFD, although serum sodium level was not significantly associated with PFD after adjustment with serum chloride level (p=0.58). Both pts with persistent hypochloremia (HR 8.92[2.39-33.3]) and progressive hypochloremia (HR 3.74[1.18-11.8]), but not those with improved hypochloremia, had a significantly greater risk of PFD than those without hypochloremia during hospitalization.
Conclusion: Both persistent hypochloremia and progressive hypochloremia during hospitalization, but not hyponatremia, were associated with pump failure death in patients with acute decompensated heart failure.
Author Disclosures: T. Kondo: None. T. Yamada: None. T. Morita: None. Y. Furukawa: None. S. Tamaki: None. Y. Iwasaki: None. M. Kawasaki: None. A. Kikuchi: None. T. Ozaki: None. Y. Sato: None. M. Seo: None. I. Ikeda: None. E. Fukuhara: None. J. Nakamura: None. M. Abe: None. M. Fukunami: None.
- © 2016 by American Heart Association, Inc.