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Low serum chloride in patients with chronic heart failure: clinical associations and prognostic significance

Cuthbert, Joseph J.; Pellicori, Pierpaolo; Rigby, Alan; Pan, Daniel; Kazmi, Syed; Shah, Parin; Clark, Andrew L.


Pierpaolo Pellicori

Alan Rigby

Daniel Pan

Syed Kazmi

Parin Shah

Andrew L. Clark


© 2018 The Authors. European Journal of Heart Failure © 2018 European Society of Cardiology Background: Low serum chloride is common in patients with chronic heart failure (CHF) and is associated with worse outcomes. We investigated the clinical and prognostic associations, including cause of death associations, of low serum chloride in patients referred to a secondary care clinic with suspected heart failure. Methods and results: Patients with echocardiogram and serum chloride were evaluated (n = 5613). CHF was defined as signs and symptoms of the disease and either left ventricular systolic dysfunction (LVSD) worse than mild [heart failure with reduced ejection fraction (HFrEF)] or LVSD mild or better and raised amino-terminal pro-B-type natriuretic peptide (NT-proBNP) levels (>125 ng/L) [heart failure with preserved ejection fraction (HFpEF)]. Hypochloraemia was defined as greater than two standard deviations below the mean in the local normal distribution (


Cuthbert, J. J., Pellicori, P., Rigby, A., Pan, D., Kazmi, S., Shah, P., & Clark, A. L. (2018). Low serum chloride in patients with chronic heart failure: clinical associations and prognostic significance. European journal of heart failure, 20(10), 1426-1435.

Journal Article Type Article
Acceptance Date May 23, 2018
Online Publication Date Jun 26, 2018
Publication Date Oct 10, 2018
Deposit Date Jul 3, 2018
Publicly Available Date Oct 27, 2022
Print ISSN 1388-9842
Electronic ISSN 1879-0844
Publisher Wiley
Peer Reviewed Peer Reviewed
Volume 20
Issue 10
Pages 1426-1435
Keywords Heart failure; Chloride; Outcome; Hypochloraemia; Diuretics; Prognosis
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