Ortiz-Cortés Carolina, Rey-Sánchez Purificación, Gómez-Turégano Paula, Bover-Freire Ramón, Calderón-García Julián F, Gómez-Barrado Jose Javier, Rico-Martín Sergio
Cardiology Department, Hospital Universitario Fundación de Alcorcón, 28922 Madrid, Spain.
Department of Nursing, Colegio de Enfermería y Terapia Ocupacional, Universidad de Extremadura, 10003 Cáceres, Spain.
Nutrients. 2025 Sep 8;17(17):2899. doi: 10.3390/nu17172899.
: Nutritional disorders are common in patients with heart failure (HF) and are associated with reduced functional capacity and poor prognosis. In this study, we evaluated the prognostic, nutritional and functional impact of a structured nutritional intervention in patients with chronic HF at risk of malnutrition. : This is a prespecified subanalysis of the randomized controlled trial . Ambulatory patients with chronic HF at risk of malnutrition were identified using the Mini Nutritional Assessment (MNA) questionnaire and randomized to receive either an individualised nutritional intervention (intervention group) or standard care (control group). We evaluated the frequency of malnutrition risk and the impact of the intervention on clinical outcomes, defined as a composite of all-cause mortality or time to first HF hospitalisation, as well as nutritional status and functional capacity at 3- and 12-month follow-ups. : A total of 225 patients were screened. Of these, 72 (32%) were identified as being at risk of malnutrition and 64 (28.4%) met the inclusion criteria and were randomized (31 in the intervention group and 33 in the control group). There were no significant differences between the groups in terms of all-cause mortality or time to first HF hospitalisation (HR = 0.34 [0.11-1.09]; = 0.072). At 12 months, the intervention group demonstrated a significant improvement in functional capacity, with an increase of 31.3 metres in the 6-minute walk test (6MWT) ( = 0.002), whereas no significant change was observed in the control group. Nutritional status improved significantly in the intervention group (MNA score +4.12, < 0.001) and declined in the control group (-1.15, = 0.029). At 12 months, body mass index, tricipital skinfold thickness, arm circumference, and serum albumin levels increased in the intervention group. : A structured and individualised nutritional intervention significantly improved nutritional status and functional capacity over 12 months, although it did not impact major clinical outcomes.
营养失调在心力衰竭（HF）患者中很常见，并且与功能能力下降和预后不良相关。在本研究中，我们评估了结构化营养干预对有营养不良风险的慢性HF患者的预后、营养和功能影响。 ：这是一项随机对照试验的预先指定的亚分析。使用微型营养评定（MNA）问卷识别有营养不良风险的慢性HF门诊患者，并随机分为接受个体化营养干预（干预组）或标准护理（对照组）。我们评估了营养不良风险的频率以及干预对临床结局的影响，临床结局定义为全因死亡率或首次HF住院时间的综合指标，以及在3个月和12个月随访时的营养状况和功能能力。 ：共筛查了225例患者。其中，72例（32%）被确定有营养不良风险，64例（28.4%）符合纳入标准并被随机分组（干预组31例，对照组33例）。两组在全因死亡率或首次HF住院时间方面无显著差异（风险比=0.34[0.11 - 1.09]；P = 0.072）。在12个月时，干预组的功能能力有显著改善，6分钟步行试验（6MWT）增加了31.3米（P = 0.002），而对照组未观察到显著变化。干预组的营养状况显著改善（MNA评分+4.12，P < 0.001），而对照组下降（-1.15，P = 0.029）。在12个月时，干预组的体重指数、三头肌皮褶厚度、上臂围和血清白蛋白水平升高。 ：尽管结构化个体化营养干预未影响主要临床结局，但在12个月内显著改善了营养状况和功能能力。
