Luu Tam Ngan, Ha Thuy Phuong
Department of Nutrition, Cho Ray Hospital, Ho Chi Minh City, Vietnam.
Medicine (Baltimore). 2025 Jun 13;104(24):e42941. doi: 10.1097/MD.0000000000042941.
Malnutrition is a common problem in patients with chronic heart failure, affecting the prognosis of readmission and mortality. The aim of this study is to evaluate the effects of high-energy, high-protein nutritional supplementation on hospitalized patients with chronic heart failure combined with malnutrition. A randomized, open-label, controlled clinical study was performed from October 2020 to May 2022 at the Department of Cardiology, Cho Ray Hospital. Forty patients were randomly selected for the intervention (diet with high-energy, high-protein nutritional supplementation) and control groups (normal diet). Of the 40 patients included in this study, 21 were randomized into the intervention group and 19 into the control group. The mean age of participants was 65.53 ± 19.20 years; 24 (60%), 14 (35%), and 2 (5%) patients were classed as New York Heart Association grade II, grade III, and grade IV, respectively. The prevalence of malnutrition at admission was 65% based on body mass index (BMI) and 80% based on the subjective global assessment. The rates of severe malnutrition in the control and the intervention groups were 21.1% and 38.1%, respectively, based on BMI, and 84.21% and 76.19% based on subjective global assessment. The intervention group had an actual total energy intake of 1560.80 ± 80.32 kcal, higher than the recommended intake of 1377.54 ± 69.27 kcal (P = .03). Following the nutritional intervention, weight, BMI, phase angle, handgrip strength, and serum prealbumin significantly increased in the intervention group. None of the patients in either group developed symptoms of gastrointestinal intolerance. The mean hospital stay was 7.15 ± 1.38 days, with no statistically significant difference between the intervention and control groups. High-energy, high-protein oral nutritional supplementation helps improve nutritional status for patients hospitalized with chronic heart failure, as shown by changes in body weight, BMI, phase angle, handgrip strength, and serum prealbumin. Furthermore, this nutrition regimen was well-tolerated, and no gastrointestinal adverse events were observed.
营养不良是慢性心力衰竭患者的常见问题，会影响再入院预后和死亡率。本研究旨在评估高能量、高蛋白营养补充对合并营养不良的慢性心力衰竭住院患者的影响。2020年10月至2022年5月，在乔雷医院心内科进行了一项随机、开放标签、对照临床研究。随机选择40例患者分为干预组（高能量、高蛋白营养补充饮食）和对照组（正常饮食）。本研究纳入的40例患者中，21例随机分为干预组，19例分为对照组。参与者的平均年龄为65.53±19.20岁；24例（60%）、14例（35%）和2例（5%）患者分别被归类为纽约心脏协会II级、III级和IV级。根据体重指数（BMI），入院时营养不良的患病率为65%，根据主观全面评定法为80%。根据BMI，对照组和干预组的严重营养不良率分别为21.1%和38.1%，根据主观全面评定法分别为84.21%和76.19%。干预组的实际总能量摄入量为1560.80±80.32千卡，高于推荐摄入量1377.54±69.27千卡（P = 0.03）。营养干预后，干预组的体重、BMI、相位角、握力和血清前白蛋白显著增加。两组均无患者出现胃肠道不耐受症状。平均住院天数为7.15±1.38天，干预组和对照组之间无统计学显著差异。高能量、高蛋白口服营养补充有助于改善慢性心力衰竭住院患者的营养状况，体重、BMI、相位角、握力和血清前白蛋白的变化表明了这一点。此外，这种营养方案耐受性良好，未观察到胃肠道不良事件。
