Takeaway
- In patients with chronic heart failure (CHF), malnutrition and congestion (raised right atrial pressure [RAP], pulmonary artery systolic pressure and right ventricular systolic dysfunction [RVSD]) are modestly associated with each other and each is independently associated with increased mortality.
Why this matters
- Study findings have clinical implications as patients with malnutrition and congestion are at high risk and should be managed with additional vigilance.
Study design
- Longitudinal observational study enrolled 1058 patients; CHF was confirmed in 952 patients (males, 69%; median age, 75 years).
- Patients were screened for malnutrition using the Geriatric Nutritional Risk Index (GNRI).
- Primary endpoint was all-cause mortality.
- Funding: None disclosed.
Key results
- 461 (44%) patients died during a median follow-up of 1683 days.
- 14% of patients with CHF were malnourished (GNRI ≤98; mild malnutrition: 10%; moderate to severe malnutrition: 4%).
- Malnutrition was more common in patients with heart failure with a reduced ejection fraction than heart failure with normal ejection fraction (17% vs 12%; P=.01).
- Simultaneous presence of RVSD and increased RAP was much more common in malnourished patients than in non-malnourished patients (33% vs 17%, P<.001)
- N-terminal pro brain natriuretic peptide (OR, 5.7; 95% CI, 3.2-10.1; P<.001) was strongly associated with malnutrition, followed by trans-tricuspid gradient (OR, 1.11; 95% CI, 1.0-1.2; P=.03).
Limitations
- Single-centre study.
- Observational design.
References
References
