Lactate and acute heart failure syndrome

Abstract

This chapter discusses the different pathways of lactate metabolism and the mechanisms by which hyperlactatemia could appear during acute heart failure. The clinical practical interpretation of hyperlactatemia requires repeated lactate measurement. In all cases, it must be compared with the clinical situation and other biologic parameters. Hyperlactatemia entails a poor prognosis, especially if it is persistent. But even though it has been considered deleterious for a long time, recent data show that lactate is probably a key metabolic intermediate substrate during acute energetic crisis. Thus, hyperlactatemia, and more precisely a high lactate turnover, may be viewed as an adaptive or protective response to acute illness. Neither low pH nor hyperlactatemia requires a specific treatment (1). © 2008 Springer-Verlag London.