Objective:To evaluate the predictive value of persistent hypochloremia for 1-year all-cause mortali-ty in patients with heart failure with preserved ejection fraction(HFpEF).Methods:A total of 329 patients with HFpEF who were discharged from the Department of Cardiology,Fujian Provincial People's Hospital from Januar-y 2021 to December 2022 were retrospectively collected.The patients were divided into four groups according to the mean blood chloride quartile level during hospitalization:Q1 group(mean blood chloride＜98.0 mmol/L),Q2 group(98.0 mmol/L≤ mean blood chloride＜101.5 mmol/L),Q3 group(101.5 mmol/L≤ mean blood chloride＜104.5 mmol/L)and Q4 group(mean blood chloride≥104.5 mmol/L).Regular outpatient or telephone follow-up were conducted after discharge.Kaplan-Meier survival curve was used to compare the 1-year survival rate a-mong the four groups.Cox regression analysis was used to analyze the risk factors of 1-year all-cause death.ROC curve was used to evaluate the predictive value of average blood chlorine during hospitalization and the blood chlo-rine on admission for 1-year death.Results:The 1-year all-cause mortality rates in Q1,Q2,Q3,and Q4 groups after discharge were 11.0％,4.9％,3.7％,and 1.2％,respectively.Kaplan-Meier survival curve analysis showed that the 1-year survival rate in discharged patients with persistent hypochloriemia was lower than those with transient hypochloriemia(P=0.025).Multivariate Cox regression analysis showed that the mean blood chlo-ride was an independent risk factor for 1-year all-cause death in HFpEF patients(HR=1.29,95％CI:1.10-1.42,P=0.033).The area under the ROC curve of the average blood chlorine during hospitalization and the blood chlorine on admission for predicting 1-year all-cause death were 0.819 and 0.698 respectively.Conclusion:The average blood chlorine level during hospitalization is correlated with the 1-year poor prognosis of HFpEF pa-tients,and its predictive value for the 1-year prognosis is greater than the single admission blood chlorine level.
heart failure with preserved ejection fractionhypochloremiaprognosis
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