Department of Cardiology, Cardiovascular Center, Anjo Kosei Hospital, Anjo, Japan.
Department of Advanced Cardiovascular Therapeutics, Nagoya University Graduate School of Medicine, Nagoya, Japan.
J Card Fail. 2020 Jul;26(7):566-573. doi: 10.1016/j.cardfail.2020.02.005. Epub 2020 Feb 29.
Undernutrition is a negative predictor of adverse outcomes in patients with heart failure (HF). Despite the survival advantage of elevated body mass index (BMI) in patients with HF, BMI does not necessarily reflect a favorable nutritional status. In the present study, we investigated the clinical impact of nutritional screening in patients with HF and overweight/obesity.
We examined the data from 170 patients with overweight or obesity status (defined as BMI ≥ 25 kg/m) who admitted for acute HF. Their controlling nutritional status (CONUT) score was calculated on admission. The CONUT score is regarded as an index of the nutritional status.
The median duration of follow-up was 1096 days (interquartile range, 805-1096 days). Undernutrition was identified in 66.5% of the patients. Kaplan-Meier survival analysis demonstrated that patients with undernutrition had a higher incidence of all-cause death and readmission due to HF than those without undernutrition. Multivariate Cox regression analysis revealed that the CONUT score, but not BMI and the geriatric nutritional risk index, was independently correlated with poor prognosis.
Undernutrition is highly prevalent and independently predicts poor outcomes in patients with overweight/obesity and acute HF.
营养不良是心力衰竭（HF）患者不良预后的负面预测因子。尽管心力衰竭患者的体重指数（BMI）升高具有生存优势，但 BMI 并不一定反映良好的营养状况。在本研究中，我们研究了营养筛查对超重/肥胖心力衰竭患者的临床影响。
我们检查了 170 名超重或肥胖患者（BMI≥25kg/m）的数据，这些患者因急性 HF 入院。入院时计算了他们的控制营养状况（CONUT）评分。CONUT 评分被视为营养状况的指标。
中位随访时间为 1096 天（四分位间距，805-1096 天）。营养不良在 66.5%的患者中被识别出来。Kaplan-Meier 生存分析表明，与无营养不良的患者相比，营养不良的患者全因死亡和因 HF 再次入院的发生率更高。多变量 Cox 回归分析显示，CONUT 评分，而不是 BMI 和老年营养风险指数，与预后不良独立相关。
超重/肥胖和急性 HF 患者中营养不良的发生率很高，且独立预测不良预后。
