心力衰竭中的氯离子：被忽视的电解质。

Chloride in Heart Failure: The Neglected Electrolyte.

作者信息

Zandijk Arietje J L, van Norel Margje R, Julius Florine E C, Sepehrvand Nariman, Pannu Neesh, McAlister Finlay A, Voors Adriaan A, Ezekowitz Justin A

机构信息

Department of Medicine, University Medical Center Groningen, Groningen, the Netherlands.

Canadian VIGOUR Centre, University of Alberta, Edmonton, Alberta, Canada; Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.

出版信息

JACC Heart Fail. 2021 Dec;9(12):904-915. doi: 10.1016/j.jchf.2021.07.006. Epub 2021 Oct 6.

DOI:10.1016/j.jchf.2021.07.006

PMID:34857174

Abstract

The increasing burden of heart failure (HF) and emerging knowledge regarding chloride as a prognostic marker in HF have increased the interest in the pathophysiology and interactions of chloride abnormalities with HF-related factors and treatments. Chloride is among the major electrolytes that play a unique role in fluid homeostasis and is associated with cardiorenal and neurohormonal systems. This review elucidates the role of chloride in the pathophysiology of HF, evaluates the effects of treatment on chloride (eg, diuretic agents cause higher urinary chloride excretion and consequently serum hypochloremia), and discusses recent evidence for the association between chloride levels and mortality.

摘要

心力衰竭（HF）负担的不断增加，以及关于氯化物作为HF预后标志物的新知识不断涌现，这使得人们对氯化物异常的病理生理学及其与HF相关因素和治疗的相互作用越来越感兴趣。氯化物是主要电解质之一，在液体平衡中发挥独特作用，并与心肾和神经激素系统相关。本综述阐明了氯化物在HF病理生理学中的作用，评估了治疗对氯化物的影响（例如，利尿剂导致尿氯化物排泄增加，进而导致血清低氯血症），并讨论了氯化物水平与死亡率之间关联的最新证据。