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Malnutrition is highly prevalent in patients with heart failure (HF), but the precise impact of dietary energy deficiency on HF patients’ clinical outcomes is not known. We investigated the associations between inadequate calorie intake and adverse clinical events in 145 stable outpatients with chronic HF who had a history of hospitalization due to worsening HF. To assess the patients’ dietary pattern, we used a brief self-administered diet-history questionnaire (BDHQ). Inadequate calorie intake was defined as <60% of the estimated energy requirement. In the total chronic HF cohort, the median calorie intake was 1628 kcal/day. Forty-four patients (30%) were identified as having an inadequate calorie intake. A Kaplan–Meier analysis revealed that the patients with inadequate calorie intake had significantly worse clinical outcomes including all-cause death and HF-related hospitalization during the 1-year follow-up period versus those with adequate calorie intake (20% vs. 5%, p < 0.01). A multivariate logistic regression analysis showed that inadequate calorie intake was an independent predictor of adverse clinical events after adjustment for various factors that may influence patients’ calorie intake. Among patients with chronic HF, inadequate calorie intake was associated with an increased risk of all-cause mortality and rehospitalization due to worsening HF. However, our results are preliminary and larger studies with direct measurements of dietary calorie intake and total energy expenditure are needed to clarify the intrinsic nature of this relationship.

Aims The aim of this study was to compare the diagnostic performance of the nutritional indicators, the mini nutritional assessment‐short form (MNA‐SF), the geriatric nutritional risk index (GNRI), and the controlling nutritional status (CONUT), in heart failure (HF) patients. Methods and results Nutritional status was prospectively assessed by the aforementioned three nutritional indicators in 150 outpatients with HF who were then followed for 1 year. The prevalence of patients with the nutritional risk as assessed by the MNA‐SF, GNRI, and CONUT scores was 50.0%, 13.3%, and 54.0%, respectively. There was slight agreement of nutritional risk assessment between the MNA‐SF and GNRI scores (κ coefficient = 0.16), as well as the GNRI and CONUT scores (κ = 0.11), but poor agreement between the MNA‐SF and CONUT scores (κ = −0.09). The CONUT score had the lowest area under the curve (AUC) for the identification of low body weight, low muscle mass, and low physical function among the three indicators (all P < 0.05). Compared with the MNA‐SF score, both the GNRI and CONUT scores had lower AUCs for the identification of reduced dietary intake and weight loss (all P < 0.05). There was no significant difference in predicting all‐cause mortality or HF rehospitalization among the three indicators. The prescription of statins reduced the diagnostic performance of the CONUT score, as the CONUT score includes cholesterol level assessment. Conclusions Of the three indicators, the diagnostic ability of the MNA‐SF score was the highest, and that of the CONUT score was the lowest, for the assessment of HF patient nutritional status. The CONUT score may misrepresent nutritional status, particularly in patients receiving statins.

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L-Carnitine supplementation in heart failure patients with preserved ejection fraction; a pilot study Time course P value Change from baseline to 12 months P value Baseline 12 months within each group group difference Body composition Body weight (kg) Carnitine 57.82 ± 16.59

Abstract.[Purpose] The purpose of this study was to clarify the relationship between cardiorespiratory fitness and metabolic markers, including leptin, in healthy young adults.[Subjects] The subjects were 51 healthy young men (mean age, 21.6 years; range, 18-31 years).[Methods] Ventilatory threshold and maximal oxygen uptake were measured on a cycle ergometer. The metabolic markers, HDL-cholesterol, triglyceride, fasting glucose, fasting insulin and leptin, were also measured, as well as and body composition, body height, body weight, percentage fat mass, waist circumference, and hip circumference. Blood pressure levels were recorded at rest.[Results] Our results show that lower cardiorespiratory fitness was significantly associated with higher storage of fat, lipid markers of developing atherosclerosis, and circulating leptin levels. Higher circulating leptin levels were also associated with metabolic risk markers such as obesity and insulin resistance.[Conclusion] Our results suggest that appropriate cardiorespiratory fitness may improve circulating metabolic markers even in healthy young men. It is therefore important that all persons should have high cardiorespiratory fitness from an early period of life for the effective prevention of cardiovascular disease.