Original Research Received: August 18, 2014 Accepted after revision: February 2, 2015 Published online: May 6, 2015
Cardiology 2015;131:151–159 DOI: 10.1159/000377669
Chloride Depletion Alkalosis as a Predictor of Inhospital Mortality in Patients with Decompensated Heart Failure Nazia Naz S. Khan a Muhammad Nabeel c Bin Nan d Jalal K. Ghali b
a Department of Internal Medicine, Wayne State University School of Medicine and b Detroit Medical Center Cardiovascular Institute, Department of Medicine, Wayne State University, Detroit, Mich., c Department of Medicine, Michigan State University and Spectrum Health Medical Group, Grand Rapids, Mich., and d Division of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, Mich., USA
Abstract Objectives: Chloride depletion alkalosis (CDA) is often seen as a consequence of diuresis in heart failure (HF) but its prognostic significance remains unknown. The purpose of this study was to evaluate the prognostic role of CDA in decompensated HF (DHF). Methods: A retrospective cohort analysis was performed on 674 patients who were admitted with DHF. Patients were assigned to 2 groups based on the change in serum bicarbonate (median = 3 mmol/l) after diuresis, which was calculated by computing the difference in the admission and discharge serum bicarbonate: the CDA group (a change in serum bicarbonate ≥3 mmol/l) and the non-CDA group (change in serum bicarbonate
Cardiology 2015;131:151–159 DOI: 10.1159/000377669
Chloride Depletion Alkalosis as a Predictor of Inhospital Mortality in Patients with Decompensated Heart Failure Nazia Naz S. Khan a Muhammad Nabeel c Bin Nan d Jalal K. Ghali b
a Department of Internal Medicine, Wayne State University School of Medicine and b Detroit Medical Center Cardiovascular Institute, Department of Medicine, Wayne State University, Detroit, Mich., c Department of Medicine, Michigan State University and Spectrum Health Medical Group, Grand Rapids, Mich., and d Division of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, Mich., USA
Abstract Objectives: Chloride depletion alkalosis (CDA) is often seen as a consequence of diuresis in heart failure (HF) but its prognostic significance remains unknown. The purpose of this study was to evaluate the prognostic role of CDA in decompensated HF (DHF). Methods: A retrospective cohort analysis was performed on 674 patients who were admitted with DHF. Patients were assigned to 2 groups based on the change in serum bicarbonate (median = 3 mmol/l) after diuresis, which was calculated by computing the difference in the admission and discharge serum bicarbonate: the CDA group (a change in serum bicarbonate ≥3 mmol/l) and the non-CDA group (change in serum bicarbonate
