Relationship between Nutritional Status and Clinical and Biochemical Parameters in Hospitalized Patients with Heart Failure with Reduced Ejection Fraction, with 1-year Follow-Up

Abstract

Heart Failure (HF) is a cardiovascular disease with continually increasing morbidity and high mortality. The purpose of this study was to analyze nutritional status in patients diagnosed with HF with reduced ejection fraction (HFrEF) and evaluate the impact of malnutrition on their prognosis. The Polish version of MNA form (Mini Nutritional Assessment) was used to assess the patients’ nutritional status. The New York Heart Association (NYHA) class, exacerbation of HF, chosen echocardiographic and biochemical parameters, e.g. natriuretic peptides or serum albumin, were also analyzed. Among the 120 consecutive patients, 47 (39%) had a normal nutritional status, 62 (52%) were at risk of malnutrition and 11 (9%) were malnourished. The patients with malnutrition more frequently presented with HF exacerbation in comparison to those with normal nutritional status (82% vs. 30% respectively, p = 0.004). There were no significant differences between the investigated groups as to natriuretic peptides; however, both the malnourished patients and those at risk of malnutrition tend to show higher B-type natriuretic peptide (BNP) and NT-proBNP concentrations. During the average 344 days of follow-up 19 patients died and 25 were hospitalized due to decompensated HF. Malnutrition or being at risk of malnutrition seems to be associated with both worse outcomes and clinical status in HFrEF patients.

Appetite and Nutritional Status as Potential Management Targets in Patients with Heart Failure with Reduced Ejection Fraction—The Relationship between Echocardiographic and Biochemical Parameters and Appetite

“…We observed a higher heart rate on admission in the group consisting of malnourished patients and at risk of malnutrition compared with a well-nourished group. This finding was proven by another study [13]. We also observed statistically higher BNP levels in patients with the inappropriate nutritional status, whereas Aggarwal et al did not show any association between the nutritional status and natriuretic peptides [10].…”

“…In our study, the number of patients with HFrEF and malnutrition or being at risk of malnutrition according to MNA score was smaller than in other studies using MNA to assess the nutritional status [9][10][11]13]. In our study, 55% of patients had the impaired nutritional status, i.e., were at risk of malnutrition or malnourished.…”

“…Reduced desire to eat and related malnutrition may contribute to the deterioration of cardiac cachexia and consequently worsen the prognosis [ 32 , 33 ]. Even 90% of HF patients may experience malnutrition [ 8 , 9 , 10 , 11 , 12 , 13 ], which is considered a factor of patients’ life quality [ 14 , 31 ].…”

“…The exact prevalence of malnutrition is difficult to evaluate due to the lack of standardized methods of diagnosis. In hospitalized patients with chronic HF, the prevalence of nutritional risk ranges from 34% to 90%, depending on the applied screening tools and the investigated population [ 8 , 9 , 10 , 11 , 12 , 13 ].…”

The Association between Nutritional Status and In-Hospital Mortality among Patients with Heart Failure—A Result of the Retrospective Nutritional Status Heart Study 2 (NSHS2)

“…The malnutrition status in HF patients is undoubtedly related to the quality of life, risk of re-hospitalisation, prolonged hospitalisation, complications, and increased risk of death during in-patient treatment [ 14 ]. Consequently, disease-related malnutrition significantly increases medical costs, and its importance in the course of the disease remains underappreciated [ 15 , 16 ]. In this study, using the univariate analysis, the risk of malnutrition more than doubled the risk of death in HF patients (HR = 2.31; p = 0.014).…”