J Cardiovasc Nurs. 2021;36(6):565-572. doi: 10.1097/JCN.0000000000000819.
Possible sarcopenia, aortic valve stenosis, and malnutrition are important issues that afflict older adults.
The aims of this study were to compare the differences in nutritional status and family support in older adults with possible sarcopenia and those without sarcopenia after undergoing transcatheter aortic valve implantation (TAVI) and to identify the predictors of malnutrition and demonstrate changes in heart function over time after undergoing TAVI.
A case-control design was conducted. Possible sarcopenia was identified by measuring calf circumference, grip strength, and gait speed. The Mini Nutritional Assessment-Short Form and numerical family support rating scale were used to collect data. Left ventricular ejection fraction and New York Heart Association (NYHA) functional class were assessed at 5 time points to evaluate heart function.
Eighty-one participants were categorized into those without sarcopenia (34) and those with possible sarcopenia (47). Logistic linear regression showed albumin and possible sarcopenia to be predictors of malnutrition (odds ratio, 5.5; 95% confidence interval, 1.02-30.19). Family support was associated with nutrition status (P = .019). For patient heart function, the results of NYHA functional class and left ventricular ejection fraction improved over time after TAVI. The improvement in NYHA functional class at T2 was significantly different between the 2 groups compared with that at T0.
The nutrition level was higher among participants without sarcopenia than those with possible sarcopenia. Approximately 90% of the participants indicated that they had high family support. Demographic factors and albumin levels could be used to evaluate risk of malnutrition. Patients without possible sarcopenia showed greater improvement in NYHA class.
可能的肌肉减少症、主动脉瓣狭窄和营养不良是困扰老年人的重要问题。
本研究旨在比较经导管主动脉瓣置换术（TAVI）后可能存在和不存在肌肉减少症的老年人在营养状况和家庭支持方面的差异，确定营养不良的预测因素，并随着时间的推移展示 TAVI 后心脏功能的变化。
采用病例对照设计。通过测量小腿围、握力和步速来确定可能的肌肉减少症。使用微型营养评估-简短表格和数字家庭支持评分量表来收集数据。在 5 个时间点评估左心室射血分数和纽约心脏协会（NYHA）功能分级，以评估心脏功能。
81 名参与者分为无肌肉减少症组（34 人）和可能存在肌肉减少症组（47 人）。逻辑线性回归显示白蛋白和可能存在的肌肉减少症是营养不良的预测因素（优势比，5.5；95%置信区间，1.02-30.19）。家庭支持与营养状况相关（P=.019）。对于患者的心脏功能，TAVI 后 NYHA 功能分级和左心室射血分数随着时间的推移而改善。与 T0 相比，T2 时 2 组 NYHA 功能分级的改善有显著差异。
无肌肉减少症组的营养水平高于可能存在肌肉减少症组。约 90%的参与者表示他们得到了很高的家庭支持。人口统计学因素和白蛋白水平可用于评估营养不良的风险。无肌肉减少症的患者在 NYHA 分级方面有更大的改善。
