Individualized Nutritional Support for Hospitalized Patients With Chronic Heart Failure

Hersberger, Lara; Dietz, Anna; Bürgler, Helene; Bargetzi, Annika; Bargetzi, Laura; Kaegi-Braun, Nina; Tribolet, Pascal; Gomes, Filomena; Hoess, Claus; Pavlíček, V.; Bilz, Stefan; Sigrist, Sarah; Brändle, Michael; Henzen, Christoph; Thomann, Robert V.; Rutishauser, Jonas; Aujesky, Drahomir; Rodondi, Nicolas; Donzé, Jacques; Stanga, Zeno; Müeller, Beat; Schuetz, Philipp

doi:10.1016/j.jacc.2021.03.232

Cited by 88 publications

(74 citation statements)

References 37 publications

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“…To the best of our knowledge, the present study is the first to link gut microbiota to AA metabolic disturbances in patients with HF. A recent study demonstrated that individualized nutritional support reduced the risk of major cardiovascular events and mortality in patients with chronic HF ( 51 ). Thus, the gut microbiota may be useful in patient nutritional risk stratification.…”

Section: Discussionmentioning

confidence: 99%

Uncovering the Role of Gut Microbiota in Amino Acid Metabolic Disturbances in Heart Failure Through Metagenomic Analysis

Hayashi

Yamashita

Takahashi

et al. 2021

Front. Cardiovasc. Med.

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Aims: Circulating amino acid (AA) abnormalities serve as predictors of adverse outcomes in patients with heart failure (HF). However, the role of the gut microbiota in AA disturbances remains unknown. Thus, we investigated gut microbial functions and their associations with AA metabolic alterations in patients with HF.Methods and Results: We performed whole-genome shotgun sequencing of fecal samples and mass spectrometry-based profiling of AAs in patients with compensated HF. Plasma levels of total essential AAs (EAAs) and histidine were significantly lower in patients with HF than in control subjects. HF patients also displayed increased and decreased abundance of gut microbial genes involved in the degradation and biosynthesis, respectively, of EAAs, including branched-chain AAs (BCAAs) and histidine. Importantly, a significant positive correlation was observed between the abundance of microbial genes involved in BCAA biosynthesis and plasma BCAA levels in patients with HF, but not in controls. Moreover, network analysis revealed that the depletion of Eubacterium and Prevotella, which harbor genes for BCAA and histidine biosynthesis, contributed to decreased abundance of microbial genes involved in the biosynthesis of those EAAs in patients with HF.Conclusions: The present study demonstrated the relationship between gut microbiota and AA metabolic disturbances in patients with HF.

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Section: Discussionmentioning

confidence: 99%

Uncovering the Role of Gut Microbiota in Amino Acid Metabolic Disturbances in Heart Failure Through Metagenomic Analysis

Hayashi

Yamashita

Takahashi

et al. 2021

Front. Cardiovasc. Med.

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“…A recent randomized controlled trial which recruited 2,088 medical inpatients at nutritional risk found that the use of individualized nutritional support during the hospital stay improved clinical outcomes, compared with the use of standard hospital food ( 55 ). The strong evidence that individualized nutritional support can improve the prognosis of patients with HF is worth learning ( 56 ). The benefits of eating plans adjusted by the patient's preference, food fortifications, and oral nutritional supplements have been proved ( 57 , 58 ).…”

Section: Discussionmentioning

confidence: 99%

Nutritional Risk Index Improves the GRACE Score Prediction of Clinical Outcomes in Patients With Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention

Shao

et al. 2021

Front. Cardiovasc. Med.

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Background: Malnutrition has been shown to be associated with adverse cardiovascular outcomes in many patient populations.Aims: To investigate the prognostic significance of malnutrition as defined by nutritional risk index (NRI) in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI) and whether NRI could improve the GRACE score based prognostic models.Methods: This study applied NRI among 1,718 patients with ACS undergoing PCI. Patients were divided into three nutritional risk groups according to their baseline NRI: no nutritional risk (NRI ≥ 100), mild nutritional risk (97.5 ≤ NRI <100), and moderate-to-severe nutritional risk (NRI <97.5). The primary endpoint was the composite of major adverse cardiovascular events (MACE), including all-cause death, non-fatal stroke, non-fatal myocardial infarction, or unplanned repeat revascularization.Results: During a median follow-up of 927 days, 354 patients developed MACE. In the overall population, compared with normal nutritional status, malnutrition was associated with increased risk for MACE [adjusted HR for mild and moderate-to-severe nutritional risk, respectively: 1.368 (95%CI 1.004–1.871) and 1.473 (95%CI 1.064–2.041)], and NRI significantly improved the predictive ability of the GRACE score for MACE (cNRI: 0.070, P = 0.010; IDI: 0.005, P < 0.001). In the diabetes subgroup, malnutrition was associated with nearly 2-fold high adjusted risk of MACE, and the GRACE score combined with NRI appeared to have better predictive ability than that in the overall population.Conclusion: Malnutrition as defined by NRI was independently associated with MACE in ACS patients who underwent PCI, especially in individuals with diabetes, and improved the predictive ability of the GRACE score based prognostic models.

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“…It was approved by the ethics committee of Northwestern Switzerland (EKNZ; 2014_001) and was registered at ClinicalTrials.gov in August 2015 ( https://clinicaltrials.gov/ct2/show/NCT02517476 ). The trial protocol, 14 the main results 10 as well as results regarding long-term outcomes, 15 cost outcomes 16 and results of secondary analyses 12 , 13 , 17 , 18 , 19 , 20 , 21 , 22 have been published previously. All patients provided written informed consent.…”

Section: Methodsmentioning

confidence: 99%

Admission serum albumin concentrations and response to nutritional therapy in hospitalised patients at malnutrition risk: Secondary analysis of a randomised clinical trial

et al. 2022

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Individualized Nutritional Support for Hospitalized Patients With Chronic Heart Failure

Cited by 88 publications

References 37 publications

Uncovering the Role of Gut Microbiota in Amino Acid Metabolic Disturbances in Heart Failure Through Metagenomic Analysis

Uncovering the Role of Gut Microbiota in Amino Acid Metabolic Disturbances in Heart Failure Through Metagenomic Analysis

Nutritional Risk Index Improves the GRACE Score Prediction of Clinical Outcomes in Patients With Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention

Admission serum albumin concentrations and response to nutritional therapy in hospitalised patients at malnutrition risk: Secondary analysis of a randomised clinical trial

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