Relationship between enteral nutrition and serum levels of inflammatory factors and cardiac function in elderly patients with heart failure

Abstract

ObjectiveTo investigate enteral nutrition’s effect on serum inflammatory factors and the cardiac function of malnourished elderly patients with heart failure.Patients and methodsA total of 105 elderly patients with heart failure were randomly divided into 3 groups: Treatment Group A, Treatment Group B, and the Control Group (Group C), each group having 35 patients and being administered conventional heart failure treatment. Group A was treated with 500 mL·d−1 of enteral nutrition for 1 month. Group B was given the same dose of enteral nutrition for 3 months. The Control Group was given free diet. Nutritional risk screening 2002 was used to assess the nutritional status before and after the treatment for each group. New York Heart Association status was recorded as were left ventricular ejection fraction, plasma B-type natriuretic peptide, inteleukin-6, C-reactive protein, and tumor necrosis factor-α.ResultsAfter the treatment, the body mass index, skinfold thickness of upper arm triceps, muscle circumference of the upper arm, upper arm muscle circumference, total protein, albumin, hemoglobin, and left ventricular ejection fraction in the treatment groups all increased, with relatively obvious relief of symptoms of heart failure. The levels of B-type natriuretic peptide, interleukin-6, tumor necrosis factor-α, and C-reactive protein all rose to different extents (P<0.05) and Treatment Group B showed more obvious improvement (P<0.01). Differences shown by the Control Group in each nutrition indicator, serum levels of inflammatory factors, and cardiac function had no statistical significance (P>0.05).ConclusionThe use of enteral nutrition in conventional treatment of elderly patients with heart failure could improve not only patients’ nutritional status and cardiac function, but also their immune function, thus reducing the levels of inflammatory factors. The longer the treatment period is, the more obvious the improvement in patients’ cardiac function and inflammatory factors will be observed.

Range of plasma brain natriuretic peptide (BNP) levels in hemodialysis patients at a high risk of 1-year mortality and their relationship with the nutritional status: a retrospective cohort study in one institute

“…After the administration of a high-caloric (600 kcal), high-protein (20 g), and oral nutritional supplement for 6 weeks to cachexic heart failure patients, significant improvements were observed in the quality of life, 6-m walking test, and tumor necrosis factor-α without the significant recovery of peak VO 2 or the left ventricular ejection fraction; BNP was not measured in that study [21]. After the administration of 500 mL/day of enteral nutrition for 3 months to elderly heart failure patients, marked improvements were noted in BNP, interleukin-6, tumor necrosis factor-α, and C-reactive protein levels [22]. After adjustments for transthyretin levels, the risk associated with BNP ≥ 500 pg/mL was no longer significant.…”

“…After adjustments for transthyretin levels, the risk associated with BNP ≥ 500 pg/mL was no longer significant. Transthyretin is an important indicator of not only the nutritional status, but also the survival of hemodialysis patients after adjustments for age, gender, race, hemodialysis vintage, the diabetic state, and nutritional markers, including serum albumin levels [22,23]. A recent study reported that serum transthyretin levels correlated with body fat mass [24].…”

Mid‐arm muscle circumference as an indicator of exercise tolerance in chronic heart failure

“…Several studies have reported that anthropometric indicators are a measure of muscle mass, 12,13 and muscle mass is associated with exercise tolerance [3][4][5] in patients with CHF. However, the direct association between anthropometric indicators and exercise tolerance in CHF has not been investigated to date.…”

“…12 Several previous studies have used mid-arm muscle circumference (MAMC) as an indicator of nutritional status and muscle mass in patients with CHF. 13,14 Anthropometric indicators are advantageous for assessment, as they are easily evaluable in routine clinical practice with no associated costs. However, to our knowledge, the association between anthropometric indicators and exercise tolerance in patients with CHF has not been investigated.…”

Guidelines for parenteral and enteral nutrition in geriatric patients in China

“…The longer the treatment time, the greater the improvement in cardiac function and inflammatory factors. 61 Use of PN is safe and well tolerated during the perioperative period in patients with heart failure who are treated with ventricular assistance devices. 62 …”