Endocrinology and Nutrition Department, La Fe University and Polytechnic Hospital in Valencia, 46026 Valencia, Spain.
Joint Research Unit on Endocrinology, Nutrition and Clinical Dietetics, Health Research Institute La Fe, 46026 Valencia, Spain.
Nutrients. 2024 Aug 26;16(17):2853. doi: 10.3390/nu16172853.
Heart failure (HF) is associated with significant alterations in body composition, including malnutrition due to insufficient intake, chronic inflammation and increased energy expenditure. Identifying the prevalence of malnutrition and the risk of sarcopenia in patients with HF is crucial to improve clinical outcomes.
This cross-sectional, single-center, observational study involved 121 outpatients diagnosed with HF. Nutritional status was assessed using the Mini Nutritional Assessment (MNA), the Malnutrition Universal Screening Tool (MUST), and the Subjective Global Rating (SGA). Sarcopenia was screened using the SARC-F (Strength, Assistance in walking, Rise from a chair, Climb stairs, Falls) questionnaire and diagnosed based on the European Working Group in Older People (EWGSOP2) criteria and functionality with the Short Performance Battery (SPPB) test. Malnutrition was diagnosed according to the Global Leadership Initiative on Malnutrition (GLIM) criteria.
The study found that 10.7% had cardiac cachexia and 45.4% of deceased patients had been in this condition ( = 0.002). Moderate-to-high risk of malnutrition was identified in 37.1%, 23.9%, and 31.4% of patients according to the MNA, MUST, and SGA tests, respectively. According to the GLIM criteria, 56.2% of patients were malnourished. Additionally, 24.8% of patients had a high probability of sarcopenia, and 57.8% were not autonomous according to SPPB. Patients with less than 30% quadriceps muscle contraction were at a high risk of sarcopenia.
There is a high prevalence of malnutrition among outpatients with HF, which is associated with worse prognosis, increased risk of sarcopenia, and greater frailty. These findings underscore the importance of early nutritional and functional assessments in this population to improve clinical outcomes.
心力衰竭（HF）与身体成分的重大变化有关，包括由于摄入不足引起的营养不良、慢性炎症和能量消耗增加。确定 HF 患者的营养不良和肌少症风险的患病率对于改善临床结局至关重要。
这是一项横断面、单中心、观察性研究，涉及 121 名被诊断为 HF 的门诊患者。使用迷你营养评估（MNA）、营养不良通用筛查工具（MUST）和主观全面评估（SGA）评估营养状况。使用 SARC-F（力量、行走辅助、从椅子上站起来、爬楼梯、跌倒）问卷筛查肌少症，并根据欧洲老年人工作组（EWGSOP2）标准和功能使用短程体能测试（SPPB）进行诊断。根据全球营养不良倡议（GLIM）标准诊断营养不良。
研究发现，10.7%的患者有心衰恶液质，45.4%的死亡患者处于这种状态（=0.002）。根据 MNA、MUST 和 SGA 测试，分别有 37.1%、23.9%和 31.4%的患者存在中重度营养不良风险。根据 GLIM 标准，56.2%的患者存在营养不良。此外，24.8%的患者有发生肌少症的高概率，根据 SPPB，57.8%的患者不能自主活动。股四头肌收缩少于 30%的患者发生肌少症的风险较高。
HF 门诊患者的营养不良患病率较高，与预后较差、肌少症风险增加和虚弱程度增加相关。这些发现强调了在该人群中早期进行营养和功能评估的重要性，以改善临床结局。
