Gajewski Piotr, Wilk Michał Maksymilian, Aleksandrowicz Krzysztof, Ponikowska Beata, Zymliński Robert
Institute of Heart Diseases, Wroclaw Medical University, 50-556 Wrocław, Poland.
Student Scientific Organization, Institute of Heart Diseases, Wroclaw Medical University, 50-556 Wrocław, Poland.
Int J Mol Sci. 2025 Jul 16;26(14):6810. doi: 10.3390/ijms26146810.
This narrative review explores the multifaceted role of lactate in heart failure (HF), focusing on its diagnostic and prognostic significance in both acute and chronic HF. Lactate functions not only as a marker of hypoperfusion and anaerobic metabolism but also as an active metabolic substrate. In acute HF, elevated lactate levels often signal circulatory insufficiency and predict adverse outcomes. In chronic HF, especially HFpEF, lactate dynamics during exercise reflect metabolic inefficiency and correlate with functional impairment. This review emphasizes the dual nature of lactate and discusses its potential utility in risk stratification and therapeutic guidance.
本叙述性综述探讨了乳酸在心力衰竭（HF）中的多方面作用，重点关注其在急性和慢性HF中的诊断和预后意义。乳酸不仅作为低灌注和无氧代谢的标志物，还作为一种活性代谢底物。在急性HF中，乳酸水平升高常提示循环功能不全并预测不良预后。在慢性HF，尤其是射血分数保留的HF（HFpEF）中，运动期间的乳酸动态变化反映了代谢效率低下，并与功能损害相关。本综述强调了乳酸的双重性质，并讨论了其在风险分层和治疗指导中的潜在用途。
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