Frailty syndrome (FS) has recently attracted attention as one of the major predictors of heart failure (HF) course severity. We aimed to develop a simple tool for predicting frailty in hospitalized HF patients using routine clinical parameters. A total of 153 hospitalized patients diagnosed with heart failure with reduced ejection fraction (HFrEF) were included in the study. Presence of FS was assessed with the SHARE-FI questionnaire. Clinical and biochemical parameters were collected. Using ROC curves and logistic regression analysis, a model predicting FS presence was developed and tested. Proposed model includes five variables with following cut-off values (1 point for each variable): age > 50 years, systolic pressure on admission < 110 mmHg, total cholesterol < 4.85 mmol/L, bilirubin ≥ 15.5 mmol/L, and alanine aminotransferase ≤ 34 U/L. Receiving 5 points was considered a high risk of FS with positive and negative predictive values (NPV), 83% and 72%, respectively, and specificity of 97%. Awarding 2 points or less ruled out FS in the studied group with negative predictive value 94%. The presented novel, simple score predicts FS in HFrEF patients with routine clinical parameters and has good positive and negative predictive values.

This study aimed to investigate the role of appetite loss and malnutrition in patients with heart failure with reduced ejection fraction (HFrEF). In this prospective, observational, single-center study, we enrolled 120 consecutive adults with HFrEF. We analyzed the selected clinical, echocardiographic, and biochemical parameters. Appetite loss and malnutrition were assessed by CNAQ (Council on Nutrition Appetite Questionnaire) and MNA (Mini Nutritional Assessment)/GNRI (Geriatric Nutritional Risk Index) questionnaires, respectively.Most patients were men (81.7%), mean age was 55.1 ± 11.3 years, and mean left ventricular ejection fraction was 23.9 ± 8.0%. The mean CNAQ score was 28.8 ± 3.9, mean MNA—23.1 ± 2.6, and mean GNRI—113.0 ± 12.3. Based on ROC curves, we showed that a sodium concentration <138 mmol/L had the greatest discriminating power for diagnosing impaired nutritional status (MNA ≤ 23.5) with a sensitivity of 54.5% and specificity of 77.8%. The threshold of HDL <0.97 mmol/L characterized 40.7% sensitivity and 86% specificity, B-type natriuretic peptide >738.6 pg/dL had 48.5% sensitivity and 80.8% specificity, high-sensitivity C-reactive protein >1.8 mg/L had 94.9% sensitivity and 42.9% specificity, and bilirubin >15 µmol/L had 78.2% sensitivity and 56.9% specificity. Nutritional status and appetite assessed by MNA/GNRI and CNAQ questionnaires showed poor correlations with other findings in HFrEF patients.

Despite significant advances in HF diagnosis and treatment over the recent decades, patients still characterize poor long-term prognosis with many recurrent hospitalizations and reduced health-related quality of life (HRQoL). We aimed to check the potential relationship between clinical, biochemical, or echocardiographic parameters and HRQoL in patients with HF with reduced ejection fraction (HFrEF). We included 152 adult patients hospitalized due to chronic HFrEF. We used the WHOQoL-BREF questionnaire to assess HRQoL and GNRI to evaluate nutritional status. We also analyzed several biochemical parameters and left ventricle ejection fraction. Forty (26.3%) patients were hospitalized due to HF exacerbation and 112 (73.7%) due to planned HF evaluation. The median age was 57 (48–62) years. Patients with low somatic HRQoL score had lower transferrin saturation (23.7 ± 11.1 vs. 29.7 ± 12.5%; p = 0.01), LDL (2.40 (1.80–2.92) vs. 2.99 (2.38–3.60) mmol/L; p = 0.001), triglycerides (1.18 (0.91–1.57) vs. 1.48 (1.27–2.13) mmol/L; p = 0.006) and LVEF (20 (15–25) vs. 25 (20–30)%; p = 0.003). TIBC (64.9 (58.5–68.2) vs. 57.7 (52.7–68.6); p = 0.02) was significantly higher in this group. We observed no associations between HRQoL and age or gender. The somatic domain of WHOQoL-BREF in patients with HFrEF correlated with the clinical status as well as biochemical and echocardiographic parameters. Assessment of HRQoL in HFrEF seems important in everyday practice and can identify patients requiring a special intervention

Funding Acknowledgements Type of funding sources: None. Background/Introduction Heart failure (HF) is increasing steadily while the prognosis still stays poor despite improvements in care and availability of new therapies. The nutritional status. is important in management of HF, as an part of multidisciplinary approach. It is known that the diet depends on the availability of nutritional products and therefore also on the season. The seasonal differences of the nutritional status in HF to our knowledge has not been studied before. Purpose The assessment of variability in nutritional status among patients with heart failure with reduced ejection fraction (HFrEF) in different seasons of the year. Methods We enrolled 240 consecutive patients hospitalized at the department of cardiology, due to HFrEF with left ventricular ejection fraction (LVEF) &lt;=40%. Patients were interviewed with MNA form to assess their nutritional status. Detailed medical history was collected. Patients were divided according to the astronomical season of the year (spring summer fall winter), depending on the time of the admission to the hospital. We compared MNA scores between mentioned groups of patients using U Mann Whitney test. Due to the possible influence of HF exacerbations on nutritional status, the second analysis was done after exclusion of patients with HF decompensation. Results Mean age was 56.4±11.3 years, 15.8 % patients were women, mean BMI – 28.8±5.5 kg/m2, mean LVEF – 23.9±7.7%, mean MNA score – 23.0±2.9 points. MNA score was higher (the sign of better nutritional status) in patients interviewed during spring compared to those assessed in summer (p=0.0094) or fall (p=0.014). The same situation was observed after the exclusion of patients with decompensation of HF: MNA score measured in patients admitted in spring was better than those hospitalized in summer (p=0.042) or fall (p=0.0064). The difference between spring and winter lacked statistical significance (p=0.058). Mean MNA scores and more important data for every season are presented in Figure 1 and 2. Conclusion(s) The differences in nutrition state in stable patients with HFrEF suggest that the seasonality of the diet might result from veritable modification in nutrition associated with availability and price of fruit and vegetables or the respondents mood, unrelated to the real nutritional status, impacts the score in the MNA questionnaire. This requires further analyses.

Funding Acknowledgements Type of funding sources: None. Introduction Heart failure (HF) patients are exposed to severe symptoms of the disease, fatal prognosis, rehospitalizations and low quality of life status. Furthermore, it was observed that more patients with HF would rather live better than longer. Purpose The aim of the study was to determine the relationship between clinical parameters, natriuretic peptides level and quality of life (QoL) in patients with heart failure with reduced ejection fraction. Methods 111 patients hospitalized due to heart failure with reduced ejection fraction (HFrEF) were examined using WHOQOL-BREF questionnaire and divided into three groups of similar quantity due to their transformed score of somatic domain of QoL: first group with score &lt;45 - worst QoL (n = 33), second group with score between 45 and 55 (n = 42), and third with score &gt;55 - best QoL (n = 36). Then the group with highest scores, with best somatic QoL, was compared with those with lowest scores in respect of chosen clinical and biochemical parameters. Results Patients with the highest somatic domain score, comparing with the lowest, had significantly higher BMI (mean 29.8 ± 5.5 vs. 26.8 ± 5.7 kg/m2, p = 0.016), lower BNP level (465 vs. 967 pg/ml, median 275 vs. 690, p =0.005), higher LVEF (30.7 ± 12.0 vs. 23.9 ± 10.8%, p = 0.006), higher triglycerides level (2.02 ± 1.22 vs. 1.43 ± 0.76 mmol/l, p = 0.027) and iron level (17.8 ± 6.6 vs. 13.6 ± 5.5 µmol/l, p = 0.019) as well as transferrin saturation (28.0 ± 11.0 vs. 21.3 ± 8.9 %, p = 0.015). The percentage of patients with NYHA class I and II was higher in the group with the highest somatic domain score in comparison with the lowest (66.6% vs. 33.3% respectively, p = 0.034). Conclusions The somatic domain of WHOQOL-BREF in patients with HFrEF correlates with patients’ clinical state assessed with the NYHA class and BNP level. QoL status was not associated with age and gender which are depicted in the literature as the important aspects influencing QoL of the community.