Effects of enteral nutrition on heart function, inflammatory markers and immune function in elderly patients with chronic heart failure

Abstract

Objectives: To evaluate the effect of enteral nutrition on heart function, inflammatory markers and immune function in elderly patients with chronic heart failure and its clinical significance.
 Methods: Eighty patients with moderate and severe heart failure admitted to the Cardiology Intensive Care Unit (CCU) of Baoding First Central Hospital from May 2019 to May 2020 were included in this study and randomly divided into two groups: the experimental group and the control group, with 40 patients in each group. The experimental group was given enteral nutrition support therapy on the basis of conventional therapy for one month, while the control group was given restricted salt and water intake on the basis of conventional therapy, and patients were given free diet according to their wishes. The changes in heart function before and after treatment, changes in inflammatory factors such as TNF-a, CRP, IL-6, changes in levels of immunoglobulins such as IgA, IgM, and IgG, and the improvement of the performance status of the two groups were compared and analyzed.
 Results: After treatment, indicators such as BNP, LVEDD, LVEF and 6min walking distance in the experimental group were significantly improved compared with the control group, with statistically significant differences (p<0.05), and the levels of inflammatory factors such as TNF-a, CRP and IL-6 in the experimental group were significantly reduced compared with those in the control group (p=0.00). The levels of IgG, IgA, IgM and other immunoglobulins in the experimental group improved more significantly after treatment than those in the control group, with statistically significant differences (IgG, IgA, p=0.00; IgM, p=0.01). Moreover, the experimental group was significantly superior to the control group in the improvement rate of performance status score (ECOG) after treatment (p=0.04); The incidence of gastrointestinal adverse reactions in the experimental group was 20%, and that in the control group was 15%. No statistically significant difference can be observed in the gastrointestinal tolerance of both groups (p=0.56).
 Conclusions: Reasonable enteral nutrition boasts a variety of benefits for the recovery of elderly patients with chronic heart failure. With reasonable enteral nutrition, the heart function of elderly patients with chronic heart failure can be significantly improved, inflammatory factors can be reduced, immunity and performance status can be enhanced, and gastrointestinal tolerance can be ameliorated without obvious gastrointestinal reactions.
 doi: https://doi.org/10.12669/pjms.38.1.4451
 How to cite this:Zhang D, Li H, Tian X, Zhang S. Effects of enteral nutrition on heart function, inflammatory markers and immune function in elderly patients with chronic heart failure. Pak J Med Sci. 2022;38(1):---------. doi: https://doi.org/10.12669/pjms.38.1.4451
 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Effect of Traditional Chinese Exercises on Patients with Chronic Heart Failure (TCE-HF): A Systematic Review and Meta-Analysis

“…Usual care ( n = 36) included routine treatment and nursing, therapeutic drugs, dietary and exercise advice, standard medical supervision, lifestyle guidance, mental health advice, and an education program. A total of 33 studies (80.49%) were conducted in Asian countries [ 12 , 13 , 15 , 16 , 17 , 18 , 19 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 ], five (19.23%) in the United States [ 14 , 37 , 38 , 39 , 40 ], one (3.85%) in Italy [ 11 ], one (3.85%) in the United Kingdom [ 10 ] and one in Sweden [ 41 ]. The time and frequency of exercise varied among studies.…”

Clinical evidence and potential mechanisms of traditional Chinese medicine for refractory heart failure: a literature review and perspectives

“…Echocardiography Shenfu injection ( 61 – 63 ), Shenmai injection ( 57 , 64 ), Astragalus injection ( 65 ), Sofre Injection ( 55 ), and Xinmailong injection ( 54 ) improve cardiac function, reduce LVEDD, LVEDV, LVESD, and LVESV levels, increase fraction shortening (FS) levels, and increase LVEF. Shenfu injection ( 61 , 62 ), Shenmai injection ( 64 , 66 ), Sofre injection ( 55 ), and Salviae Miltiorrhizae and Ligustrazine Hydrochloride injection ( 67 ) can increase SV. Shenfu injection ( 63 ) and Shenmai injection ( 57 , 64 ) increase the output per minute (CO).…”

“…Biochemical indicators Shenfu injection ( 51 , 61 ), Shenqi injection ( 68 ), Astragalus injection ( 65 ), Salviae Miltiorrhizae and Ligustrazine Hydrochloride injection ( 67 ), Xinmailong injection ( 58 , 69 ), and Yiqifumai injection ( 59 ) can reduce the levels of NT-proBNP or BNP. Shenfu injection ( 61 – 63 ) can reduce the levels of inflammatory factors hs-CRP and IL-6, and it can also reduce the levels of CK-MB, cTnT, E-selection (ES), and H-FABP, and alleviate myocardial injury.…”

“…Xinmailong injection ( 58 ) can improve pulmonary artery systolic pressure (PASP), mean pulmonary artery pressure (MPAP), endothelin (ET), nitric oxide (NO), thromboxane (TXA2), and prostacyclin (PGI2), reduce pulmonary artery pressure, and alleviate vascular endothelial function damage. Salviae Miltiorrhizae and Ligustrazine Hydrochloride injection ( 67 ) increased systolic blood pressure (SBP), diastolic blood pressure (DBP), and estimated glomerular filtration rate (eGFR) levels, decreased plasma renin activity, angiotensin II, serum creatinine (SCr), and aldosterone (ALD) levels, and inhibited the activation of renin-angiotensin-aldosterone system (RAAS).…”

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