{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T06:53:49Z","timestamp":1789541629020,"version":"build-2803163510"},"reference-count":42,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2022,2,16]],"date-time":"2022-02-16T00:00:00Z","timestamp":1644969600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,3,16]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Acute heart failure (AHF) may be associated with low-tissue perfusion and\/or hypoxaemia leading to increased lactate levels and acid\u2013base perturbations. Few data are available on the clinical significance of elevated lactate levels and primary acid\u2013base disorders in the setting of AHF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>Arterial blood gas was obtained at admission in 4012 normotensive (systolic blood pressure\u2009\u2265\u200990\u2009mmHg) patients with AHF. The association between lactate levels and acid\u2013base status and in-hospital mortality was determined using multivariable logistic regression. Hyperlactataemia (&amp;gt;2\u2009mmol\/L) was present in 38.0% of patients and was strongly associated with markers of sympathetic activation, such as hyperglycaemia. Hyperlactataemia was present in 31.0%, 43.7%, and 42.0% of patients with normal pH, acidosis, and alkalosis, respectively. In-hospital mortality occurred in 16.4% and 11.1% of patients with and without hyperlactataemia [adjusted odds ratio (OR) 1.49; 95% confidence interval (CI) 1.22\u20131.82, P\u2009&amp;lt;\u20090.0001]. Compared with normal pH, the OR for in-hospital mortality was 2.48 (95% CI 1.95\u20133.16, P\u2009&amp;lt;\u20090.0001) in patients with acidosis and 1.77 (95% CI 1.32\u20132.26, P\u2009&amp;lt;\u20090.0001) in patients with alkalosis. The risk for in-hospital mortality was high with acidosis (18.1%) or alkalosis (10.4%) even with normal lactate. The most common primary acid\u2013base disturbances included metabolic acidosis, respiratory acidosis, and metabolic alkalosis with respiratory acidosis having the highest risk for in-hospital mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Hyperlactataemia was common in patients without hypotension and was associated with increased risk for in-hospital mortality. Hyperlactataemia is not associated with any specific acid\u2013base disorder. Acute heart failure patients also present with diverse acid\u2013base disorders portending increased in-hospital mortality.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ehjacc\/zuac005","type":"journal-article","created":{"date-parts":[[2022,1,26]],"date-time":"2022-01-26T15:19:19Z","timestamp":1643210359000},"page":"242-251","source":"Crossref","is-referenced-by-count":8,"title":["Hyperlactataemia and acid\u2013base disturbances in normotensive patients with acute heart failure"],"prefix":"10.1093","volume":"11","author":[{"given":"Omer","family":"Bar","sequence":"first","affiliation":[{"name":"Department of Cardiology, Rambam Health Care Campus, Bat Galim, POB 9602, Haifa 31096, Israel"},{"name":"Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7177-843X","authenticated-orcid":false,"given":"Doron","family":"Aronson","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Rambam Health Care Campus, Bat Galim, POB 9602, Haifa 31096, Israel"},{"name":"Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,2,16]]},"reference":[{"key":"2022031720350569000_zuac005-B1","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1186\/s13054-014-0503-3","article-title":"Sepsis-associated hyperlactatemia","volume":"18","author":"Garcia-Alvarez","year":"2014","journal-title":"Crit Care"},{"key":"2022031720350569000_zuac005-B2","doi-asserted-by":"crossref","first-page":"1457","DOI":"10.1126\/science.143.3613.1457","article-title":"Excess lactate: an index of reversibility of shock in human patients","volume":"143","author":"Broder","year":"1964","journal-title":"Science"},{"key":"2022031720350569000_zuac005-B3","doi-asserted-by":"crossref","first-page":"2309","DOI":"10.1056\/NEJMra1309483","article-title":"Lactic acidosis","volume":"371","author":"Kraut","year":"2014","journal-title":"N Engl J Med"},{"key":"2022031720350569000_zuac005-B4","doi-asserted-by":"crossref","first-page":"582","DOI":"10.1164\/rccm.201812-2342OC","article-title":"Understanding lactatemia in human sepsis. 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