Abstract 18863: Prognostic Value of Persistent Hypochloremia in Patients With Chronic Heart Failure: A Comparative Study With Persistent Hyponatremia
Backgrounds: Recently, it has been reported that hypochloremia is associated with poor outcome in chronic heart failure (CHF) pts, but the prognostic significance of persistent hypochloremia (per-hypoCl) remains to be unclear. On the other hand, hyponatremia is a well-established strong predictor of mortality in CHF pts, and it was also reported that persistent hyponatremia (per-hypoNa) would be more significantly associated with unfavorable outcome in CHF pts. However, there is no information available on the comparison of the prognostic value between per-hypoCl and per-hypoNa in CHF pts.
Methods and Results: We studied 119 CHF outpatients with LVEF <40% in our prospective cohort study. We measured serum chloride and sodium concentration at entry and every 6month for the initial 3 years. Per-hypoCl and per-hypoNa was defined that hypochloremia (≤99mEq/L) and hyponatremia (≤135mEq/L) was observed for more than 6 months, respectively. During a follow up period of 7.0±0.8 years, 54 patients had cardiac events, defined as readmission for worsening heart failure or sudden cardiac death (CHF/SD). At multivariate Cox analysis, per-hypoCl (p=0.029), but not per-hypoNa, was significantly associated with CHF/SD independently of LVEF (p=0.014) and serum uric acid level (p=0.0030), although hypochloremia (p<0.0001) or hyponatremia (p=0.001) at the entry and per-hypoNa (p=0.0357) showed the significant association with CHF/SD at univariate analysis. Pts with per-hypoCl had a significantly greater risk of CHF/SD (66% vs 32% p<0.0001, adjusted HR 2.3 [1.1-4.8]).
Conclusion: Persistent hypochloremia had more valuable prognostic significance for the prediction of readmission for worsening heart failure or cardiac death than persistent hyponatremia in CHF pts.
Author Disclosures: M. Seo: None. T. Yamada: None. T. Morita: None. Y. Furukawa: None. S. Tamaki: None. Y. Iwasaki: None. M. Kawasaki: None. A. Kikuchi: None. T. Kondo: None. Y. Sato: None. T. Ozaki: None. E. Fukuhara: None. I. Ikeda: None. M. Fukunami: None.
- © 2016 by American Heart Association, Inc.