Nutritional Status is Associated with Inflammation and Predicts a Poor Outcome in Patients with Chronic Heart Failure

Nakagomi, Akihiro; Kohashi, Keiichi; Morisawa, Taichirou; Kosugi, Munenori; Endoh, Ikuko; Kusama, Yoshiki; Atarashi, Hirotsugu; Shimizu, Wataru

doi:10.5551/jat.31526

Cited by 114 publications

(85 citation statements)

References 41 publications

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“…Nakagomi et al also found that malnutrition correlated with inflammation and atherosclerosis in patients with chronic heart failure and was associated with worse clinical outcomes. 37 In the present study, patients with low serum in the model with both serum albumin and hs-CRP, even compared with the models with serum albumin alone and with hs-CRP alone.…”

Section: Discrimination and Reclassification Of Serum Albumin And Hs-crpmentioning

confidence: 97%

Independent and Combined Effects of Serum Albumin and C-Reactive Protein on Long-Term Outcomes of Patients Undergoing Percutaneous Coronary Intervention

Wada

Dohi

Miyauchi

et al. 2017

Circ J

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Section: Discrimination and Reclassification Of Serum Albumin And Hs-crpmentioning

confidence: 97%

Independent and Combined Effects of Serum Albumin and C-Reactive Protein on Long-Term Outcomes of Patients Undergoing Percutaneous Coronary Intervention

Wada

Dohi

Miyauchi

et al. 2017

Circ J

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“…7,50 Moreover, low S-Alb and congestive heart failure may promote intestinal edema 51 and disturb the absorption of essential nutrients such as antioxidative vitamins and oligoelements. 52 Altogether these factors contribute to the dangerous combination of persistent inflammation and lower S-Alb concentrations that is statistically and probably also causally linked to the extremely high cardiovascular burden and mortality in ESRD. 53 The observed associations-albeit strong-may be underestimated when analyses are based on single measurements of S-Alb and CRP.…”

Section: Sarcopeniamentioning

confidence: 99%

“…Inflammatory cytokines promote PEW by acting directly on the gastrointestinal system or indirectly through affecting appetite and resting energy expenditure . Moreover, low S‐Alb and congestive heart failure may promote intestinal edema and disturb the absorption of essential nutrients such as antioxidative vitamins and oligoelements …”

mentioning

confidence: 99%

Serum albumin, inflammation, and nutrition in end‐stage renal disease: C‐reactive protein is needed for optimal assessment

Mukai

Villafuerte

Qureshi

et al. 2018

Seminars in Dialysis

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Low serum albumin (S-Alb) is a frequent feature of end-stage renal disease (ESRD) that independently predicts mortality. Serum albumin has mainly been considered a biomarker of visceral protein and immunocompetence status, fundamental to nutritional assessment. However, low S-albumin level is associated with persistent systemic inflammation and many bodies of evidence show that S-Alb has a limited role as a marker of nutritional status. We reported that a low S-Alb concentration was an independent risk factor for poor outcome in ESRD only in the presence of systemic inflammation. Moreover, the relationships between inflammatory biomarkers and outcome are confounded also by alterations in body composition (such as obese sarcopenia) and oxidative stress. Taken together, S-Alb alone should not be used as a proxy of the nutritional status in a dialysis patient. Its association with dietary intake is poor and low S-Alb values are most often non-nutritional in origin. When analyzing S-Alb to predict mortality risk in ESRD, it should always be combined with measurement of hsCRP.

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“…The association between malnutrition and inflammation has been shown in patients with chronic kidney disese and chronic heart failure 24,25 . Based on the current evidence, inflammation can play a crucial role in the development of atherosclerotic plaques in the epicardial coronary arteries and microvascular circulation of the heart 9.10 .…”

Section: Discussionmentioning

confidence: 99%

The impact of prognostic nutritional index on coronary flow reserve in patients with inflammatory bowel disease

Çalışkan¹,

Tatlısu²,

Kahraman³

et al. 2019

MMJ

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Objective:The recurring inflammation of mucosal layer of intestines is known as inflammatory bowel disease (IBD), which can be accompanied by nutritional deficiencies. The association between inflammation and coronary artery disease has been established. Coronary flow reserve (CFR), which is an established method to evaluate combined microvascular and epicardial flow of coronary arteries, can be assessed by using transthoracic echocardiography. The aim of this study was to evaluate the association of Prognostic Nutritional Index (PNI) with CFR in IBD patients. Method: This prospective study included 101 patients with IBD. These patients were compared to control group (n=32). PNI was calculated by using serum albumin level and lymphocyte count. CFR was assessed by using Doppler echocardiography. Results: Multivariate regression analysis indicated that the presence of IBD, age (>40 years) and decreased PNI (<53.8) independently predict impairment of CFR. The area under the curve (AUC) was 75.1% (95% CI:0.664-0.838), and PNI levels were significant predictor of low CFR (p<0.001). Conclusion: This study showed that PNI, which is calculated using the serum level of albumin and lymphocyte count, is a strong predictor of decreased CFR in IBD patients in remission. Our findings support previous studies showing the relationship between PNI and coronary artery disease. This immunonutritional index has only two components and is easy to calculate, and inexpensive.Keywords: Coronary flow reserve, inflammatory bowel disease, prognostic nutritional index ÖZ Amaç: Nutrisyonel yetersizliklerin eşlik edebildiği bağırsak mukoza katmanının tekrarlayıcı inflamasyonu, inflamatuvar bağırsak hastalığı (İBH) olarak bilinmektedir. İnflamasyon ve koroner arter hastalığının ilişkisi ortaya konulmuştur. Mikrovasküler ve epikardiyal akımı kombine bir şekilde değerlendirebilen koroner akım rezervi (KAR), transtorasik ekokardiyografi ile değerlendirilebilir. Bu çalışmanın amacı, İBH hastalarında prognostik nutrisyonel indeks (PNI) ile KAR arasındaki ilişkiyi değerlendirmekti. Yöntem: Bu çalışma, prospektif olarak dahil edilen 101 İBH hastasını içermektedir. Bu hastalar kontrol grubu (n=32) ile karşılaştırılmıştır. PNI, serum albümin düzeyi, lenfosit sayısı kullanılarak hesaplanmıştır. KAR, doppler ekokardiyografi ile değerlendirilmiştir. Bulgular: Çok değişkenli regresyon analizi İBH varlığı, yaş (>40) ve azalmış PNI'nın (<53,8) KAR'daki bozulmayı bağımsız bir şekilde predikte ettiğini ortaya çıkarmıştır. Eğri altında kalan alan (AUC) %75'di (95% CI: 0,664-0,838) ve PNI seviyesi düşük KAR için anlamlı bir prediktördü (p<0,001). Sonuç: Bu çalışma göstermiştir ki serum albümin seviyesi, lenfosit sayısı ile hesaplanan PNI, remisyondaki İBH hastalarında azalmış KAR için güçlü bir prediktördür. Çalışmamız PNI ile koroner arter hastalığı ilişkisini gösteren önceki çalışmaları desteklemektedir. Bu immunonutrisyonel indeks sadece iki komponente sahiptir, kolayca hesaplanabilir ve ucuzdur.Anahtar kelimeler: Koroner akım rezervi, inflamatuvar bağırsak h...

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Nutritional Status is Associated with Inflammation and Predicts a Poor Outcome in Patients with Chronic Heart Failure

Abstract: These data indicate that a poor nutritional status as assessed using the CONUT score and atherosclerosis as indicated by CIMT is significantly associated with inflammation and predicts poor outcomes in patients with CHF.

Cited by 114 publications

References 41 publications

Independent and Combined Effects of Serum Albumin and C-Reactive Protein on Long-Term Outcomes of Patients Undergoing Percutaneous Coronary Intervention

Independent and Combined Effects of Serum Albumin and C-Reactive Protein on Long-Term Outcomes of Patients Undergoing Percutaneous Coronary Intervention

Serum albumin, inflammation, and nutrition in end‐stage renal disease: C‐reactive protein is needed for optimal assessment

The impact of prognostic nutritional index on coronary flow reserve in patients with inflammatory bowel disease

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