Escore para avaliação do estado nutricional: seu valor na estratificação prognóstica de portadores de cardiomiopatia dilatada e insuficiência cardíaca avançada

Abstract

OBJECTIVEDevelop a method for the evaluation of patient's nutritional status through a score that expresses universal nutritional status, as well as investigate if that score would be effi cient for the prognostic stratifi cation of advanced heart failure (HF) pts. METHODSThe score was reached by the selection of evaluation methods that would quantify nutritional status: ideal body weight percentage, thickness of tricipital skinfold, percentiles for arm muscular mass circumference, albumin serum level, lymphocyte total count. In order to be validated, the score was applied to a group of 95 pts. Pts were under 65 years old no evidence of consumptive diseases. The score was analyzed to confi rm whether it would keep correlation with HF clinical data and whether it would stratify its prognostic. RESULTSNutritional status suggesting moderate or severe malnutrition could be observed in 31/95 (32.6%). No correlation was found between nutritional score values and the duration of symptoms, or the level of ventricular dysfunction. Pts with high nutritional score showed a trend towards higher mortality rate (p=0.0606). CONCLUSIONSThose data suggest malnutrition is reported by 1/3 of pts with advanced HF. A score comprising 5 parameters for nutritional status showed good correlation with the clinical, global evaluation of pts with HF. A score over 8 identifi ed pts with higher probability of death as outcome, confi rming that pts under higher malnutrition exhibit worse evolution. KEY WORDSMalnutrition, cardiac cachexia, dilated cardiomyopathy.

Influência da suplementação de creatina na capacidade funcional de pacientes com Insuficiência Cardíaca

“…Our results are in accordance with those reported by Veloso et al 18 . However, Nakasato et al 15 and Nogueira et al 16 have reported most of the participants of HF studies as overweight.…”

Correlates of malnutrition in patients with heart failure: the role of social support

“…The current study also demonstrated that a longer disease duration is associated with an increased risk of malnutrition. However, previous studies did not show any relationship between the risk of malnutrition and disease duration 28 . This study also showed that lower BMI was one of the predictors of malnutrition.…”

“…However, previous studies did not show any relationship between the risk of malnutrition and disease duration. 28 This study also showed that lower BMI was one of the predictors of malnutrition. In accordance with the present result, previous studies have shown that HF patients who are malnourished tend to have a lower BMI.…”

Estado nutricional e adequação da ingestão de energia e nutrientes em pacientes com insuficiência cardíaca

“…Disproportionate mobilization and deposition of muscle and adipose tissues may occur 26 , and it is noteworthy that protein degradation plays an important role in the progression of HF 6,26,27 . The use of BMI alone, which has low sensitivity for predicting severe malnutrition among cardiac patients 7 , may not confirm the adequacy of the energy intake in patients with HF.…”