Evidence mapPaperPMID 42414833Full record

ReviewCardiology and therapy2026

The 'Chloride Theory' for Heart Failure Pathophysiology: An Updated Narrative Review 2025.

Hajime Kataoka

Abstract readReview
PubMed Publisher
In one paragraph

Review in Cardiology and therapy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

1 author.

Hajime KataokaNishida Hospital, Oita, Japan. hkata@cream.plala.or.jp.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Most studies of heart failure (HF) syndromes have focused on fluid regulation, particularly the balance of sodium and water. Approximately 10 years ago, in 2017, the "chloride theory" was proposed as a unifying hypothesis, suggesting that changes in serum chloride concentration are associated with shifts in plasma volume, hemodynamics, and neurohormonal activity during HF progression and treatment. This narrative review updates the chloride theory based on emerging clinical evidence. It further examines diuretic classification from a chloride-centered perspective, recent advances in guideline-directed medical therapy, and the potential role of chloride in loop diuretic resistance and its management. In addition, the review summarizes the prognostic relevance of changes in serum chloride during acute HF and the distinct pathophysiologic roles of sodium and chloride. Overall, this review provides an integrated perspective on HF pathophysiology, therapeutic strategies, and clinical monitoring within a chloride-centered framework.

Indexed as

AcetazolamideCardio–renal respiratory interactionChlorideDiuretic resistanceDiureticsHeart failureSGLT2 inhibitorVasopressin receptor antagonist

Identifiers

PMID42414833

What Socratic holds

Textmetadata
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.