Have you noted that patients with acute #heartfailure (AHF) hyperventilate? @JanBiegus et al. studied hyperventilation (defined by low pCO2 value) AHF and its link with potential triggers and prognosis👏nature.com/articles/s4159… @AlbertoGiannon8 @vbluml @RyanTedfordMD @yulnunezvill
1.Out of 241 AHF patients, 57 (24%) had low pCO2 (pCO2 ≤ 30 mmHg). Low pCO2 group had significantly lower HCO3- (22.3 ± 3.4 vs 24.7 ± 2.9 mmol/L, p < 0.0001) and significantly higher lactate level (2.53 ± 1.6 vs 2.14 ± 0.97 mmol/L, p = 0.03). 
2.No differences between groups were observed in respect to following potential triggers: hypoxia (sO2, p = 0.57), infection (CRP, p = 0.47), dyspnea severity and pulmonary congestion
3.Low pCO2 value was related to an increased 4-year all-cause mortality hazard ratio (HR) (95% CI) 2.2 (1.3–3.6); p = 0.002 and risk of death and of rehospitalization for HF, HR (95% CI) 2.0 (1.3–3.0); p = 0.002.
🌟In Summary: Hyperventilation is relatively frequent in AHF and is related to poor prognosis. Low pCO2 was not contingent on expected potential triggers of dyspnea but rather on tissue hypoperfusion.
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