Skip to main content
main-content

Tipp

Weitere Artikel dieser Ausgabe durch Wischen aufrufen

01.12.2016 | geriatrics: at crossroads of medicine | Sonderheft 7/2016

Wiener klinische Wochenschrift 7/2016

Nutritional status and its effects on muscle wasting in patients with chronic heart failure: insights from Studies Investigating Co-morbidities Aggravating Heart Failure

Zeitschrift:
Wiener klinische Wochenschrift > Sonderheft 7/2016
Autoren:
PhD Masakazu Saitoh, PhD Marcelo Rodrigues dos Santos, MSc Nicole Ebner, MD Amir Emami, PhD Masaaki Konishi, PhD Junichi Ishida, MD Miroslava Valentova, MD Anja Sandek, MD PhD Wolfram Doehner, MD PhD Stefan D. Anker, MD PhD Stephan von Haehling

Summary

Background

Inadequate nutritional status has been linked to poor outcomes in patients with heart failure (HF). Skeletal muscle wasting affects about 20% of ambulatory patients with HF. The impact of nutritional intake and appetite on skeletal muscle wasting has not been investigated so far. We sought to investigate the impact of nutritional status on muscle wasting and mortality in ambulatory patients with HF.

Methods

We studied 130 ambulatory patients with HF who were recruited as a part of the Studies Investigating Co-morbidities Aggravating Heart Failure (SICA-HF) program. Muscle wasting was defined according to criteria of sarcopenia, i.e., appendicular skeletal muscle mass two standard deviations below the mean of a healthy reference group aged 18–40 years. Nutritional status was evaluated using the Mini-Nutritional Assessment—Short Form (MNA-SF). Functional capacity was assessed as peak oxygen consumption (peak VO2) by cardiopulmonary exercise testing, 6‑minute walk testing, and the Short Physical Performance Battery (SPPB).

Results

At baseline, 19 patients (15%) presented with muscle wasting. Patients with muscle wasting had significantly lower values of peak VO2, 6‑minute walk distance, SPPB, and MNA-SF score than patients without (all p < 0.05). In multivariate analysis, MNA-SF remained an independent predictor of muscle wasting after adjustment for age and New York Heart Association class (odds ratio [OR] 0.66; confidence interval [CI] 0.50–0.88; p < 0.01). A total of 16 (12%) patients died during a mean follow-up of 21 months. In Cox regression analysis, MNA-SF (OR 0.80, CI 0.64–0.99, p = 0.04), left ventricular ejection fraction (OR 0.93, CI 0.86–0.99, p = 0.05), and peak VO2 (OR 0.78, CI 0.65–0.94, p = 0.008) were predictors of death.

Conclusion

MNA-SF is an independent predictor of muscle wasting and mortality in ambulatory patients with HF. Nutritional screening should be included as a fundamental part of the overall assessment of these patients.

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Literatur
Über diesen Artikel

Weitere Artikel der Sonderheft 7/2016

Wiener klinische Wochenschrift 7/2016 Zur Ausgabe

geriatrics: at crossroads of medicine

Psychocardiology in the elderly

geriatrics: at crossroads of medicine

Muscle wasting in heart failure