Cardiology · 2 h ago
Small crossover study finds acute hemodynamic changes with lactate in chronic heart failure
In a randomized, double-blind crossover study, 12 patients with chronic heart failure with reduced ejection fraction received intravenous and oral sodium lactate and matched placebos. Both routes increased cardiac output, while several other hemodynamic measures changed; the study assessed acute effects, not clinical outcomes.
- Study enrolled 12 patients with reduced-ejection-fraction heart failure.
- Both lactate routes increased cardiac output versus placebo.
- Several filling-pressure and cardiac-function measures also changed.
- Acute physiological findings do not establish clinical benefit.
Lactate is associated with adverse outcomes in acute heart failure and critical illness, but may also act as a metabolic substrate. To assess its acute hemodynamic effects in chronic heart failure, investigators conducted a randomized, double-blind crossover study in 12 patients with reduced ejection fraction. Participants received intravenous sodium lactate and saline placebo on one study day, and oral sodium lactate and isocaloric placebo on another. Hemodynamics were assessed hourly with pulmonary artery catheterization and echocardiography.
Compared with placebo, intravenous and oral lactate increased blood lactate by 2.3 mmol/L and 0.9 mmol/L, respectively. Cardiac output rose by 1.5 L/min with intravenous administration and 0.4 L/min with oral administration. Intravenous lactate also increased stroke volume and heart rate and reduced systemic vascular resistance. Oral lactate increased heart rate and reduced pulmonary capillary wedge pressure and central venous pressure. Measures of systolic and diastolic function also improved during lactate administration.
These findings indicate acute hemodynamic effects in a small, selected patient group, but do not establish clinical benefit or long-term safety. The study evaluated short-term physiological measures rather than outcomes such as hospitalization or survival; its results do not establish a role for lactate treatment in routine heart-failure care.
In practice
In 12 patients with chronic heart failure with reduced ejection fraction, a randomized crossover study found that intravenous and oral sodium lactate acutely increased cardiac output and altered other hemodynamic and echocardiographic measures. These findings are preliminary physiological evidence, not evidence that lactate improves symptoms, prevents hospitalization, or prolongs survival. The small sample and short-term assessment do not establish safety, efficacy, or a basis for changing clinical treatment.
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Critical Care: Lactate improves hemodynamics in chronic heart failure: a randomized crossover study ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.