Nutritional Status in Advanced Heart Failure and Heart Transplant Patients

Carro, Amelia; Panisello, Josefa María; Coats, Andrew J.S.

doi:10.1016/j.rec.2017.02.005

Cited by 5 publications

(9 citation statements)

References 28 publications

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“…While the International Society of Heart and Lung Transplant guidelines suggest an upper‐limit body mass index of <30 for consideration for heart transplantation, 24 official society guidelines do not provide specific parameters identifying the lower‐limit of malnutrition and determining eligibility for transplantation based on malnutrition 25‐27 . Malnutrition, however, is being increasingly recognized as a risk factor for poor outcomes, especially in the disease process of heart failure 1,12,26,28 .…”

Section: Commentmentioning

confidence: 99%

Decreased Nutritional Risk Index is associated with mortality after heart transplantation

Krishnan

Bigelow

Hsu

et al. 2021

Clinical Transplantation

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Introduction Validated scoring tools, such as the Nutritional Risk Index (NRI), can aid clinicians in quantifying the degree of malnourishment in patients prior to an operation. We evaluated the association between NRI and outcomes after heart transplantation. Methods The United Network for Organ Sharing (UNOS) database was used to identify adult patients (age > 18) undergoing heart transplantation between 1987 and 2016. NRI was calculated and categorized into previously established groupings representing severity of malnutrition. Multivariate Cox proportional hazards modeling were used to assess the primary outcome of all‐cause mortality. Results A total of 25,236 patients were included in the analysis. Most patients (75.4%) were male. Malnourishment was absent (NRI ≥ 100) in 11,022 (44%) patients, while 2,898 (12%) were mildly malnourished (97.5 ≤ NRI < 100), 8,685 (34%) were moderately malnourished (83.5 ≤ NRI < 97.5), and 2,631 (10%) were severely malnourished (NRI < 83.5). Moderate‐to‐severe malnutrition was associated with increased mortality (HR = 1.18, p < .001, 95%CI: 1.13‐1.24), and post‐transplant renal failure requiring dialysis (OR: 1.13, p < .001, 95%CI: 1.03‐1.23). Conclusion Malnourishment determined by NRI is independently associated with mortality and post‐transplant dialysis after heart transplant. This is the largest study of NRI in heart transplant recipients.

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Section: Commentmentioning

confidence: 99%

Decreased Nutritional Risk Index is associated with mortality after heart transplantation

Krishnan

Bigelow

Hsu

et al. 2021

Clinical Transplantation

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“…The association between the presence of chronic diseases and nutritional status deterioration has long been recognized, as well as the negative impact this generates on people's quality of life and, consequently, an increase in the risk of morbidity and mortality 5 .…”

Section: Introductionmentioning

confidence: 99%

Medical and nutritional implications in chronic heart failure: Strengths and limitations

Rosa¹,

Robledo-Valdez²,

Cervantes-Pérez³

et al. 2021

ACME

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Heart failure (HF) is one of the most important global public health problems, as there is an increase in its prevalence and an estimated 23 million of the world's population live with this problem. HF is defined by the presence of structural and functional abnormalities of the cardiac muscle leading to an impairment of ventricular filling and ejection. Multiple comorbidities have been associated with an increased risk of developing cardiovascular diseases. Hypertension has been recognized as one of the most important factors, however, obesity, metabolic syndrome, as well as diabetes also play an important role in the onset of the disease. It is common to find in decompensated heart failure hospitalized patients an impaired nutritional status characterized mainly by the presence of nutritional deficiencies and sarcopenia, which can sometimes progress to cachexia. Therefore, an adequate evaluation through the correct use of nutritional risk tools should be the cornerstone to the prevention of risks. Multiple anthropometric and biochemical parameters are available to establish the nutritional status of hospitalized patients, however, alterations in blood volume presented in patients with HF may alter the result of such assessment. The effectiveness of dietary modifications in the prevention and treatment of different cardiovascular diseases enhanced by appropriate adherence to eating patterns such as the DASH and Mediterranean diet have been inversely associated with the incidence of HF.

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“…Por largo tiempo se ha reconocido la asociación que existe entre la presencia de enfermedades crónicas y el deterioro del estado nutricional, así como el impacto negativo que esto genera sobre la calidad de vida en las personas y, por consiguiente, un mayor riesgo de morbilidad y mortalidad 5 .…”

Section: Introductionunclassified

Implicaciones médicas y nutricionales en insuficiencia cardiaca crónica: fortalezas y limitaciones

Rosa

Robledo-Valdez

Cervantes-Pérez

et al. 2021

ACM

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La insuficiencia cardiaca (IC) representa uno de los problemas mundiales de salud pública más importantes, ya que existe un aumento en su prevalencia y se estima que 23 millones de la población mundial viven con este problema. Esta entidad se define por la presencia de anormalidades estructurales y funcionales del músculo cardiaco que conducen a un deterioro en la capacidad del llenado y eyección ventricular. Múltiples comorbilidades se han asociado a un incremento en el riesgo de desarrollo de enfermedades cardiovasculares. La hipertensión se ha reconocido como uno de los factores más importantes, sin embargo, la obesidad, el síndrome metabólico, así como la diabetes, también juegan un papel importante en la aparición de dicha enfermedad. Es frecuente encontrar en pacientes hospitalizados con IC deterioro en el estado nutricional caracterizado principalmente por la presencia de deficiencias nutricionales y sarcopenia, que, en ocasiones, puede progresar y manifestarse como caquexia. Por lo anterior, una evaluación adecuada mediante el uso correcto de herramientas para detección de riesgo nutricional es imperativa, se hace necesaria para prevenir los riesgos que esto implica. Existen múltiples parámetros antropométricos y bioquímicos para definir el estado nutricional de los pacientes hospitalizados, sin embargo, las alteraciones en el volumen sanguíneo presentes en pacientes con IC pueden alterar el resultado de dicha evaluación. Las modificaciones dietéticas en la prevención y tratamiento de diversas enfermedades cardiovasculares mediante un buen apego a patrones de alimentación tales como la dieta DASH (enfoques dietéticos para detener la hipertensión, por sus siglas en inglés) y la dieta mediterránea se han asociado inversamente con la incidencia de IC.

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Nutritional Status in Advanced Heart Failure and Heart Transplant Patients

Cited by 5 publications

References 28 publications

Decreased Nutritional Risk Index is associated with mortality after heart transplantation

Decreased Nutritional Risk Index is associated with mortality after heart transplantation

Medical and nutritional implications in chronic heart failure: Strengths and limitations

Implicaciones médicas y nutricionales en insuficiencia cardiaca crónica: fortalezas y limitaciones

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