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The Basic Metabolic Profile in Heart Failure—Marker and Modifier

  • Biomarkers of Heart Failure (W.H.W. Tang and J.L. Grodin, Section Editors)
  • Published:
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Abstract

Purpose of Review

The physiologic determinants of each of the components of the basic metabolic profile in patients with heart failure will be explored. Additionally, the review will discuss the prognostic value of alterations in the basic metabolic profile as well as their effects on management.

Recent Findings

Abnormalities in the basic metabolic profile have significant correlation with clinical outcomes and can modify treatment in heart failure. Hypochloremia has recently received increased attention for these reasons.

Summary

Elevated creatinine, increased blood urea nitrogen, hyponatremia, and hypochloremia correlate with worse mortality and diuretic resistance in heart failure. Hypokalemia, even when mild, has proven to be a worse clinical indicator than modest elevations in serum potassium. Hypochloremia is mechanistically linked to hyponatremia and metabolic alkalosis, but recent compelling data suggests that it can provide more discriminating prognostic information. Knowledge of the physiologic basis for each of these alterations informs their management.

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Authors and Affiliations

  1. Division of Nephrology, Department of Internal Medicine, University of Texas Southwestern Medical Center, 5939 Harry Hines Blvd, MC 8516, Dallas, TX, 75390, USA

    Ahmed Elfar & Kamalanathan K. Sambandam

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  1. Ahmed Elfar
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  2. Kamalanathan K. Sambandam
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Correspondence to Kamalanathan K. Sambandam.

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Ahmed Elfar and Kamalanathan K. Sambandam declare no conflicts of interest.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Biomarkers of Heart Failure

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Elfar, A., Sambandam, K.K. The Basic Metabolic Profile in Heart Failure—Marker and Modifier. Curr Heart Fail Rep 14, 311–320 (2017). https://doi.org/10.1007/s11897-017-0344-x

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  • DOI: https://doi.org/10.1007/s11897-017-0344-x

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