Almost 75% of patients admitted for heart failure presents an inappropriate nutritional status

according to a study published in the latest issue of Spanish journal of Cardiology (REC)

-After analyzing nutritionally, for fifteen months, patients hospitalized in Hospital Reina Sofía of Córdoba, of heart failureIt was found that 13% was malnourished, 59.6 per cent were at risk of malnutrition and only 27.4 per cent presented a correct nutritional

– the State of malnutrition, most common among women, was associated with a greater cognitive impairment, a higher degree of renal failure and lower figures of index of corporal mass and prealbúmina (a type of proteí)(na)

-mortality at 25 months of follow-up of those who were suffering from malnutrition was, in absolute terms, 57% higher in relation to those who showed an adequate nutritional state

-the study confirms that the nutritional status of patients with heart failure on a regular basis should be assessed upon entering the hospital, is possible that nutritional intervention could improve their Outlook

Madrid, 2011-September the Spanish Cardiology Society (SEC) advises the high prevalence of cardiac insufficiency (CI) among the Spaniards, affecting 10,000 people by each million inhabitants, which implies that it is presentapproximately 1% of the population. Despite the progress made in their treatment, heart failure continues to produce a high morbidity and mortality, is therefore vital to find aspects that could improve the patient’s evolution.

In this regard, the unit of management clinic of cardiology at the Hospital Queen Sofia of Córdoba has developed an observational, analytical, and prospective study published in the latest issue of Spanish journal of Cardiology (REC), to demonstrate the influence of malnutrition in the prognosis of the patient’s heart failure.

To this end, made a comprehensive nutritional study that included anthropometric, biochemical parameters and survey Mini Nutritional Assessment (Nam), all patients admitted to the Centre of a CI between January 2007 and March 2008.

Each patient body mass index was calculated and assessed their body composition through the fold tricipital as an indicator of fat tissue, and muscle perimeter of the arm, as an indicator of muscle tissue. For the analysis, it was necessary to record the weight (in kilograms), the height (in centimeters), the fold tricipital (in millimeters) and the brachial average circumference (in inches). Measures were obtained in the visit to the patient the day of discharge, in accordance with the standardised methodology.

According to the rating of the Nam poll, 13% of patients with CI was malnourished, 59.6% were at risk of malnutrition and only 27.4 per cent presented a proper nutritional state.

The percentage of patients with cognitive impairment was greater in the Group of malnourished patients. In addition, presented a worse clearance of creatinine (renal grade) and lower hemoglobin figures (Metalloprotein blood that transports oxygen from the respiratory organs to tissues). This group also the percentage of women and the average age was higher than in the other two groups. With regard to the nutritional estimation parameters, patients who are undernourished according to the Mini Nutritional Assessment Survey presented under albumin and prealbúmina and a body mass index figures significantly lower.

The total mortality of patients classified as malnourished according to the survey score was 12, 25 and 32 months of follow-up, 56, 76 and 80.8% respectively; among patients at risk of malnutrition, the 23.5, the 35.9 and 42.4%, and between patients with adequate nutrition, the 11.3, the 18.9 and 26.6 per cent, so mortality at 25 months follow-up of those who were suffering from malnutrition was, in absolute terms, 57% higher for those who showed an adequate nutritional state.

The study confirms that the assessment of nutritional status should be integrated definitely as a fundamental part in the comprehensive evaluation of patients with heart failure, and can help improve your forecast.

According to Dr. Juan Luis Bonilla pigeons, a member of the SEC and optional specialist in cardiology at the Hospital Queen Sofia of Córdoba to date, widely knew how the IC was influenced in the nutritional status. Its best known effect is what classically referred to as cardiac cachexia, fruit of the catabolic state imposed by disease and whose treatment is currently none other than the IC itself. However, analysis in reverse, i.e. how the nutritional influences on the CI, offered many questions. Modestly, our study is a landmark in this area as evidence of disadvantage that malnourished IC patient facing his illness. The causes of this relationship are not enlightened although it is very possible that it is linked to the already commented fact concerned a consumptive chronic disease requiring a catabolic state. Thus, patients with worse nutritional status is a more fragile, vulnerable and worse prepared patient to deal with the disease. However, the result of our study suggests a really interesting question is if nutritional intervention aimed at optimizing the nutritional status of patients with malnourished IC could improve its outcome. The response to bring her future clinical trials designed to that effect. Only a favorable outcome would lead us to include this intervention as part of the comprehensive approach to the patient with IC ”.

Heart failure is the inability of the heart pump blood to a suitable volume to keep the needs of the human body, generating respiratory weakness. The heart may fail because of an own problem or because their reaction ability fails to satisfy what the Agency demands. Diseases such as coronary ischemic disease, valvulopathies, arrhythmias or ailments that affect the heart muscle can cause heart failure.

Spanish society of Cardiology (SEC)

The Spanish society of Cardiology (SEC) is a scientific and professional organization non-profit dedicated to increasing the State of knowledge about the heart and the circulatory system, to make progress in the prevention and treatment of their diseases and to improve survival and quality of life for heart patients.

The SEC has among its principal objectives contribute to research international, especially European and Latin American, create national and international links for the development of actions and represent all interested professionals in the field of cardiology.