Assessment of Transthyretin Combined With Mini Nutritional Assessment on Admission Provides Useful Prognostic Information in Patients With Acute Decompensated Heart Failure

Suzuki, Norio; Kida, Kenji; Suzuki, Kazuhiro; Harada, Tomoo; Akashi, Yoshihiro J.

doi:10.1536/ihj.14-255

Cited by 16 publications

(7 citation statements)

References 36 publications

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“… 27 In addition, there are significant correlations between nutritional scores (MSA, GNRI and CONUT) and both C reactive protein and natriuretic peptides in patients with decompensated HF. 28 Concordant with these findings, our data revealed that the group with more nutritional disturbance had higher mortality accompanied by higher levels of BNP, troponin I, C reactive protein, TNF-α, adiponectin, right-sided volume and pressure overload (ie, inferior vena cava diameter and TRPG). The same group had lower levels of haemoglobin and peak VO 2 , and these are reportedly prognostic factors of patients with HF.…”

Section: Discussionsupporting

confidence: 87%

Impact of nutritional indices on mortality in patients with heart failure

Yoshihisa¹,

Kanno²,

Watanabe³

et al. 2018

Open Heart

116

104

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BackgroundMalnutrition is a common condition that is associated with adverse prognosis in patients with heart failure (HF). The Prognostic Nutritional Index (PNI), Geriatric Nutritional Risk Index (GNRI) and controlling nutritional status (CONUT) have all been used as objective indices for evaluating nutritional status. We aimed to clarify the relationship between these nutritional indices and the parameters of inflammatory markers, cardiac function and exercise capacity, as well as to compare the ability of these indexes for predicting mortality.MethodsWe evaluated PNI, GNRI and CONUT in consecutive 1307 patients with HF.ResultsFirst, there were significant correlations between nutritional indices and the following: C reactive protein; tumour necrosis factor-α; adiponectin; B-type natriuretic peptide; troponin I; inferior vena cava diameter and peak VO2 (P<0.05, respectively). Second, in the Kaplan-Meier analysis (follow-up 1146 days), all-cause mortality progressively increased from normal to mild, moderate and severe disturbance groups in the indices (log-rank, P<0.01, respectively). In the Cox proportional hazard analysis, each index was an independent predictor of all-cause mortality in patients with HF (P<0.001, respectively). Third, receiver operating curve demonstrated that the areas under the curve of PNI and GNRI were larger than that of CONUT score (P<0.05, respectively).ConclusionPatients with HF being malnourished had higher mortality accompanied by higher levels of C reactive protein, tumour necrosis factor-α, adiponectin, B-type natriuretic peptide, troponin I, right-sided volume overload and impaired exercise capacity, rather than left ventricular systolic function. Additionally, PNI and GNRI were superior to CONUT score in predicting mortality in patients with HF.

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Section: Discussionsupporting

confidence: 87%

Impact of nutritional indices on mortality in patients with heart failure

Yoshihisa¹,

Kanno²,

Watanabe³

et al. 2018

Open Heart

116

104

View full text Add to dashboard Cite

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“…The reason for this higher percentage was likely advanced age. It has been reported that malnutrition may be associated with poor outcomes in ADL in other diseases, such as cerebrovascular disorders [10,11,25,26], hip fracture [29,30], hospitalassociated deconditioning [31], and heart failure [32]. In those reports and the present study, ADL was found to improve if nutritional status improved.…”

Section: Discussionsupporting

confidence: 63%

Relationship between nutritional status and improved ADL in individuals with cervical spinal cord injury in a convalescent rehabilitation ward

et al. 2019

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Study design Retrospective cohort study. Objectives To investigate the relationship of nutritional status with improvement of activities of daily living in individuals with cervical spinal cord injury. Setting A convalescent rehabilitation ward at the Toyama Prefectural Rehabilitation Hospital and Support Center for Children with Disabilities in Japan. Methods This retrospective analysis investigated adults (age ≥20 years) with cervical spinal cord injury who were consecutively admitted to a convalescent rehabilitation ward between 2006 and 2015. Data of 154 patients were analyzed. Nutritional status was evaluated using the Subjective Global Assessment (SGA; 3 groups: well-nourished, suspected of being malnourished or moderately malnourished, severely malnourished) and body mass index (BMI; 3 groups: underweight, standard, and overweight and obese). The main outcome was functional independence measure (FIM) efficiency. Multiple regression analysis was performed to investigate the relationship of SGA and BMI to FIM efficiency. Results FIM efficiency was significantly higher in the well-nourished group based on the SGA than in the two groups with malnutrition (P = .007: 0.32 vs. 0.26 vs. 0.10). Multivariate regression analysis revealed that FIM efficiency was similar in the underweight and standard group, but was significantly higher in the overweight and obese group (P = .006: 0.20 vs. 0.21 vs. 0.31). Conclusions SGA and BMI on admission may be independently associated with FIM efficiency in patients with cervical spinal cord injury.

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“…These effects trigger systemic inflammation and cytokine generation, leading to several abnormalities of cardiomyocyte function and energetics . Interestingly, the Mini Nutritional Assessment revealed that 75% of patients with AHF had malnutrition or were at risk for malnutrition, suggesting this pathophysiology is highly prevalent …”

Section: Organ Systems Impacted By Congestion In Acute Heart Failure:mentioning

confidence: 99%

“…Circulating trimethylamine N‐oxide (TMAO), a gut‐derived metabolite, is associated with AHF and is predictive of death or rehospitalization. Transthyretin (prealbumin) provides prognostic information in combination with the Mini‐Nutritional Assessment in patients with AHF …”

Section: Clinical and Biochemical Assessments Of Acute Heart Failure mentioning

confidence: 99%

Organ dysfunction, injury and failure in acute heart failure: from pathophysiology to diagnosis and management. A review on behalf of the Acute Heart Failure Committee of the Heart Failure Association (HFA) of the European Society of Cardiology (ESC)

Harjola

Mullens

Banaszewski

et al. 2017

European J of Heart Fail

298

256

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Organ injury and impairment are commonly observed in patients with acute heart failure (AHF), and congestion is an essential pathophysiological mechanism of impaired organ function. Congestion is the predominant clinical profile in most patients with AHF; a smaller proportion presents with peripheral hypoperfusion or cardiogenic shock. Hypoperfusion further deteriorates organ function. The injury and dysfunction of target organs (i.e. heart, lungs, kidneys, liver, intestine, brain) in the setting of AHF are associated with increased risk for mortality. Improvement in organ function after decongestive therapies has been associated with a lower risk for post-discharge mortality. Thus, the prevention and correction of organ dysfunction represent a therapeutic target of interest in AHF and should be evaluated in clinical trials. Treatment strategies that specifically prevent, reduce or reverse organ dysfunction remain to be identified and evaluated to determine if such interventions impact mortality, morbidity and patient-centred outcomes. This paper reflects current understanding among experts of the presentation and management of organ impairment in AHF and suggests priorities for future research to advance the field.

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Assessment of Transthyretin Combined With Mini Nutritional Assessment on Admission Provides Useful Prognostic Information in Patients With Acute Decompensated Heart Failure

Cited by 16 publications

References 36 publications

Impact of nutritional indices on mortality in patients with heart failure

Impact of nutritional indices on mortality in patients with heart failure

Relationship between nutritional status and improved ADL in individuals with cervical spinal cord injury in a convalescent rehabilitation ward

Organ dysfunction, injury and failure in acute heart failure: from pathophysiology to diagnosis and management. A review on behalf of the Acute Heart Failure Committee of the Heart Failure Association (HFA) of the European Society of Cardiology (ESC)

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