Prognostic significance of serum chloride level in heart failure patients with preserved ejection fraction
Abstract Aims The prognostic value of serum chloride level has been reported primarily in patients with heart failure with reduced ejection fraction, and hence, there is limited evidence in patients of heart failure with preserved ejection fraction (HFpEF). This study was conducted to clarify the re...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2022-04-01
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| Series: | ESC Heart Failure |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/ehf2.13840 |
| _version_ | 1818306218622451712 |
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| author | Masahiro Seo Tetsuya Watanabe Takahisa Yamada Masamichi Yano Takaharu Hayashi Akito Nakagawa Yusuke Nakagawa Shunsuke Tamaki Yoshio Yasumura Yohei Sotomi Shungo Hikoso Daisaku Nakatani Masatake Fukunami Yasushi Sakata Osaka CardioVascular Conference (OCVC)‐Heart Failure investigators |
| author_facet | Masahiro Seo Tetsuya Watanabe Takahisa Yamada Masamichi Yano Takaharu Hayashi Akito Nakagawa Yusuke Nakagawa Shunsuke Tamaki Yoshio Yasumura Yohei Sotomi Shungo Hikoso Daisaku Nakatani Masatake Fukunami Yasushi Sakata Osaka CardioVascular Conference (OCVC)‐Heart Failure investigators |
| author_sort | Masahiro Seo |
| collection | DOAJ |
| description | Abstract Aims The prognostic value of serum chloride level has been reported primarily in patients with heart failure with reduced ejection fraction, and hence, there is limited evidence in patients of heart failure with preserved ejection fraction (HFpEF). This study was conducted to clarify the relationship between serum chloride level and clinical outcomes in patients with HFpEF with acute decompensated heart failure (ADHF). Methods and results Patient data were extracted from The Prospective mUlticenteR obServational stUdy of patIenTs with Heart Failure with Preserved Ejection Fraction (PURSUIT HFpEF) study, a prospective multicentre observational registry for ADHF‐HFpEF in Osaka. The data of 870 patients were analysed after excluding patients with in‐hospital death, missing follow‐up data, missing data of serum chloride level, or on chronic dialysis therapy. The primary endpoint of this study was all‐cause mortality. At discharge, right ventricular systolic dysfunction was significantly associated with the lowest tertile of serum chloride level after multivariable adjustment (P = 0.0257). During a mean follow‐up period of 1.8 ± 1.0 years, 186 patients died. Cox multivariable analysis showed that serum chloride level at discharge (P = 0.0017) was independently associated with all‐cause mortality after multivariable adjustment of major confounders, whereas serum sodium level was no longer significant (P = 0.6761). Kaplan–Meier survival curve analysis revealed a significantly increased risk of mortality stratified by the tertile of serum chloride level [29% vs. 19% vs. 16%, P = 0.0002; hazard ratio (HR): 2.09 (95% confidence interval, CI: 1.31 to 3.34), HR: 1.03 (95% CI: 0.65 to 1.64)]. Conclusions Serum chloride level was useful for the prediction of poor outcome in ADHF patients with preserved ejection fraction. |
| first_indexed | 2024-12-13T06:39:00Z |
| format | Article |
| id | doaj.art-c194289159de4a00a9f0dca366eadeb8 |
| institution | Directory Open Access Journal |
| issn | 2055-5822 |
| language | English |
| last_indexed | 2024-12-13T06:39:00Z |
| publishDate | 2022-04-01 |
| publisher | Wiley |
| record_format | Article |
| series | ESC Heart Failure |
| spelling | doaj.art-c194289159de4a00a9f0dca366eadeb82022-12-21T23:56:28ZengWileyESC Heart Failure2055-58222022-04-01921444145310.1002/ehf2.13840Prognostic significance of serum chloride level in heart failure patients with preserved ejection fractionMasahiro Seo0Tetsuya Watanabe1Takahisa Yamada2Masamichi Yano3Takaharu Hayashi4Akito Nakagawa5Yusuke Nakagawa6Shunsuke Tamaki7Yoshio Yasumura8Yohei Sotomi9Shungo Hikoso10Daisaku Nakatani11Masatake Fukunami12Yasushi Sakata13Osaka CardioVascular Conference (OCVC)‐Heart Failure investigatorsDivision of Cardiology Osaka General Medical Center 3‐1‐56 Mandaihigashi, Sumiyoshi‐ku Osaka 558‐8558 JapanDivision of Cardiology Osaka General Medical Center 3‐1‐56 Mandaihigashi, Sumiyoshi‐ku Osaka 558‐8558 JapanDivision of Cardiology Osaka General Medical Center 3‐1‐56 Mandaihigashi, Sumiyoshi‐ku Osaka 558‐8558 JapanDivision of Cardiology Osaka Rosai Hospital Osaka JapanDivision of Cardiology Osaka Police Hospital Osaka JapanDivision of Cardiovascular Medicine Amagasaki‐Chuo Hospital Amagasaki JapanDivision of Cardiology Kawanishi City Hospital Kawanishi JapanDepartment of Cardiology Rinku General Medical Center Osaka JapanDivision of Cardiovascular Medicine Amagasaki‐Chuo Hospital Amagasaki JapanDepartment of Cardiovascular Medicine Osaka University Graduate School of Medicine Suita JapanDepartment of Cardiovascular Medicine Osaka University Graduate School of Medicine Suita JapanDepartment of Cardiovascular Medicine Osaka University Graduate School of Medicine Suita JapanDivision of Cardiology Osaka General Medical Center 3‐1‐56 Mandaihigashi, Sumiyoshi‐ku Osaka 558‐8558 JapanDepartment of Cardiovascular Medicine Osaka University Graduate School of Medicine Suita JapanAbstract Aims The prognostic value of serum chloride level has been reported primarily in patients with heart failure with reduced ejection fraction, and hence, there is limited evidence in patients of heart failure with preserved ejection fraction (HFpEF). This study was conducted to clarify the relationship between serum chloride level and clinical outcomes in patients with HFpEF with acute decompensated heart failure (ADHF). Methods and results Patient data were extracted from The Prospective mUlticenteR obServational stUdy of patIenTs with Heart Failure with Preserved Ejection Fraction (PURSUIT HFpEF) study, a prospective multicentre observational registry for ADHF‐HFpEF in Osaka. The data of 870 patients were analysed after excluding patients with in‐hospital death, missing follow‐up data, missing data of serum chloride level, or on chronic dialysis therapy. The primary endpoint of this study was all‐cause mortality. At discharge, right ventricular systolic dysfunction was significantly associated with the lowest tertile of serum chloride level after multivariable adjustment (P = 0.0257). During a mean follow‐up period of 1.8 ± 1.0 years, 186 patients died. Cox multivariable analysis showed that serum chloride level at discharge (P = 0.0017) was independently associated with all‐cause mortality after multivariable adjustment of major confounders, whereas serum sodium level was no longer significant (P = 0.6761). Kaplan–Meier survival curve analysis revealed a significantly increased risk of mortality stratified by the tertile of serum chloride level [29% vs. 19% vs. 16%, P = 0.0002; hazard ratio (HR): 2.09 (95% confidence interval, CI: 1.31 to 3.34), HR: 1.03 (95% CI: 0.65 to 1.64)]. Conclusions Serum chloride level was useful for the prediction of poor outcome in ADHF patients with preserved ejection fraction.https://doi.org/10.1002/ehf2.13840Heart failure with preserved ejection fractionSerum chloride levelRisk stratification |
| spellingShingle | Masahiro Seo Tetsuya Watanabe Takahisa Yamada Masamichi Yano Takaharu Hayashi Akito Nakagawa Yusuke Nakagawa Shunsuke Tamaki Yoshio Yasumura Yohei Sotomi Shungo Hikoso Daisaku Nakatani Masatake Fukunami Yasushi Sakata Osaka CardioVascular Conference (OCVC)‐Heart Failure investigators Prognostic significance of serum chloride level in heart failure patients with preserved ejection fraction ESC Heart Failure Heart failure with preserved ejection fraction Serum chloride level Risk stratification |
| title | Prognostic significance of serum chloride level in heart failure patients with preserved ejection fraction |
| title_full | Prognostic significance of serum chloride level in heart failure patients with preserved ejection fraction |
| title_fullStr | Prognostic significance of serum chloride level in heart failure patients with preserved ejection fraction |
| title_full_unstemmed | Prognostic significance of serum chloride level in heart failure patients with preserved ejection fraction |
| title_short | Prognostic significance of serum chloride level in heart failure patients with preserved ejection fraction |
| title_sort | prognostic significance of serum chloride level in heart failure patients with preserved ejection fraction |
| topic | Heart failure with preserved ejection fraction Serum chloride level Risk stratification |
| url | https://doi.org/10.1002/ehf2.13840 |
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