Persistent Hypochloremia Is Associated with Adverse Prognosis in Patients Repeatedly Hospitalized for Heart Failure
Background: Hypochloremia reflects neuro-hormonal activation in patients with heart failure (HF). However, the prognostic impact of persistent hypochloremia in those patients remains unclear. Methods: We collected the data of patients who were hospitalized for HF at least twice between 2010 and 2021...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-02-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/4/1257 |
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| author | Yuji Nozaki Akiomi Yoshihisa Yu Sato Himika Ohara Yukiko Sugawara Satoshi Abe Tomofumi Misaka Takamasa Sato Masayoshi Oikawa Atsushi Kobayashi Takayoshi Yamaki Kazuhiko Nakazato Yasuchika Takeishi |
| author_facet | Yuji Nozaki Akiomi Yoshihisa Yu Sato Himika Ohara Yukiko Sugawara Satoshi Abe Tomofumi Misaka Takamasa Sato Masayoshi Oikawa Atsushi Kobayashi Takayoshi Yamaki Kazuhiko Nakazato Yasuchika Takeishi |
| author_sort | Yuji Nozaki |
| collection | DOAJ |
| description | Background: Hypochloremia reflects neuro-hormonal activation in patients with heart failure (HF). However, the prognostic impact of persistent hypochloremia in those patients remains unclear. Methods: We collected the data of patients who were hospitalized for HF at least twice between 2010 and 2021 (n = 348). Dialysis patients (n = 26) were excluded. The patients were divided into four groups based on the absence/presence of hypochloremia (<98 mmol/L) at discharge from their first and second hospitalizations: Group A (patients without hypochloremia at their first and second hospitalizations, n = 243); Group B (those with hypochloremia at their first hospitalization and without hypochloremia at their second hospitalization, n = 29); Group C (those without hypochloremia at their first hospitalization and with hypochloremia at their second hospitalization, n = 34); and Group D (those with hypochloremia at their first and second hospitalizations, n = 16). Results: a Kaplan–Meier analysis revealed that all-cause mortality and cardiac mortality were the highest in Group D compared to the other groups. A multivariable Cox proportional hazard analysis revealed that persistent hypochloremia was independently associated with both all-cause death (hazard ratio 3.490, <i>p</i> < 0.001) and cardiac death (hazard ratio 3.919, <i>p</i> < 0.001). Conclusions: In patients with HF, prolonged hypochloremia over two hospitalizations is associated with an adverse prognosis. |
| first_indexed | 2024-03-11T08:39:05Z |
| format | Article |
| id | doaj.art-d15ce6ebc21b4bf4a786cb8260993b52 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-11T08:39:05Z |
| publishDate | 2023-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-d15ce6ebc21b4bf4a786cb8260993b522023-11-16T21:17:03ZengMDPI AGJournal of Clinical Medicine2077-03832023-02-01124125710.3390/jcm12041257Persistent Hypochloremia Is Associated with Adverse Prognosis in Patients Repeatedly Hospitalized for Heart FailureYuji Nozaki0Akiomi Yoshihisa1Yu Sato2Himika Ohara3Yukiko Sugawara4Satoshi Abe5Tomofumi Misaka6Takamasa Sato7Masayoshi Oikawa8Atsushi Kobayashi9Takayoshi Yamaki10Kazuhiko Nakazato11Yasuchika Takeishi12Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima 960-1247, JapanDepartment of Cardiovascular Medicine, Fukushima Medical University, Fukushima 960-1247, JapanDepartment of Cardiovascular Medicine, Fukushima Medical University, Fukushima 960-1247, JapanDepartment of Cardiovascular Medicine, Fukushima Medical University, Fukushima 960-1247, JapanDepartment of Cardiovascular Medicine, Fukushima Medical University, Fukushima 960-1247, JapanDepartment of Cardiovascular Medicine, Fukushima Medical University, Fukushima 960-1247, JapanDepartment of Cardiovascular Medicine, Fukushima Medical University, Fukushima 960-1247, JapanDepartment of Cardiovascular Medicine, Fukushima Medical University, Fukushima 960-1247, JapanDepartment of Cardiovascular Medicine, Fukushima Medical University, Fukushima 960-1247, JapanDepartment of Cardiovascular Medicine, Fukushima Medical University, Fukushima 960-1247, JapanDepartment of Cardiovascular Medicine, Fukushima Medical University, Fukushima 960-1247, JapanDepartment of Cardiovascular Medicine, Fukushima Medical University, Fukushima 960-1247, JapanDepartment of Cardiovascular Medicine, Fukushima Medical University, Fukushima 960-1247, JapanBackground: Hypochloremia reflects neuro-hormonal activation in patients with heart failure (HF). However, the prognostic impact of persistent hypochloremia in those patients remains unclear. Methods: We collected the data of patients who were hospitalized for HF at least twice between 2010 and 2021 (n = 348). Dialysis patients (n = 26) were excluded. The patients were divided into four groups based on the absence/presence of hypochloremia (<98 mmol/L) at discharge from their first and second hospitalizations: Group A (patients without hypochloremia at their first and second hospitalizations, n = 243); Group B (those with hypochloremia at their first hospitalization and without hypochloremia at their second hospitalization, n = 29); Group C (those without hypochloremia at their first hospitalization and with hypochloremia at their second hospitalization, n = 34); and Group D (those with hypochloremia at their first and second hospitalizations, n = 16). Results: a Kaplan–Meier analysis revealed that all-cause mortality and cardiac mortality were the highest in Group D compared to the other groups. A multivariable Cox proportional hazard analysis revealed that persistent hypochloremia was independently associated with both all-cause death (hazard ratio 3.490, <i>p</i> < 0.001) and cardiac death (hazard ratio 3.919, <i>p</i> < 0.001). Conclusions: In patients with HF, prolonged hypochloremia over two hospitalizations is associated with an adverse prognosis.https://www.mdpi.com/2077-0383/12/4/1257hypochloremiaserum chlorideheart failurecardiac deathall-cause death |
| spellingShingle | Yuji Nozaki Akiomi Yoshihisa Yu Sato Himika Ohara Yukiko Sugawara Satoshi Abe Tomofumi Misaka Takamasa Sato Masayoshi Oikawa Atsushi Kobayashi Takayoshi Yamaki Kazuhiko Nakazato Yasuchika Takeishi Persistent Hypochloremia Is Associated with Adverse Prognosis in Patients Repeatedly Hospitalized for Heart Failure Journal of Clinical Medicine hypochloremia serum chloride heart failure cardiac death all-cause death |
| title | Persistent Hypochloremia Is Associated with Adverse Prognosis in Patients Repeatedly Hospitalized for Heart Failure |
| title_full | Persistent Hypochloremia Is Associated with Adverse Prognosis in Patients Repeatedly Hospitalized for Heart Failure |
| title_fullStr | Persistent Hypochloremia Is Associated with Adverse Prognosis in Patients Repeatedly Hospitalized for Heart Failure |
| title_full_unstemmed | Persistent Hypochloremia Is Associated with Adverse Prognosis in Patients Repeatedly Hospitalized for Heart Failure |
| title_short | Persistent Hypochloremia Is Associated with Adverse Prognosis in Patients Repeatedly Hospitalized for Heart Failure |
| title_sort | persistent hypochloremia is associated with adverse prognosis in patients repeatedly hospitalized for heart failure |
| topic | hypochloremia serum chloride heart failure cardiac death all-cause death |
| url | https://www.mdpi.com/2077-0383/12/4/1257 |
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