+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Nutritional status and its effects on muscle wasting in patients with chronic heart failure: insights from Studies Investigating Co-morbidities Aggravating Heart Failure



Nutritional status and its effects on muscle wasting in patients with chronic heart failure: insights from Studies Investigating Co-morbidities Aggravating Heart Failure



Wiener Klinische Wochenschrift 128(Suppl 7): 497-504



Inadequate nutritional status has been linked to poor outcomes in patients with heart failure (HF). Skeletal muscle wasting affects about 20% of ambulatory patients with HF. The impact of nutritional intake and appetite on skeletal muscle wasting has not been investigated so far. We sought to investigate the impact of nutritional status on muscle wasting and mortality in ambulatory patients with HF. We studied 130 ambulatory patients with HF who were recruited as a part of the Studies Investigating Co-morbidities Aggravating Heart Failure (SICA-HF) program. Muscle wasting was defined according to criteria of sarcopenia, i.e., appendicular skeletal muscle mass two standard deviations below the mean of a healthy reference group aged 18-40 years. Nutritional status was evaluated using the Mini-Nutritional Assessment-Short Form (MNA-SF). Functional capacity was assessed as peak oxygen consumption (peak VO2) by cardiopulmonary exercise testing, 6‑minute walk testing, and the Short Physical Performance Battery (SPPB). At baseline, 19 patients (15%) presented with muscle wasting. Patients with muscle wasting had significantly lower values of peak VO2, 6‑minute walk distance, SPPB, and MNA-SF score than patients without (all p < 0.05). In multivariate analysis, MNA-SF remained an independent predictor of muscle wasting after adjustment for age and New York Heart Association class (odds ratio [OR] 0.66; confidence interval [CI] 0.50-0.88; p < 0.01). A total of 16 (12%) patients died during a mean follow-up of 21 months. In Cox regression analysis, MNA-SF (OR 0.80, CI 0.64-0.99, p = 0.04), left ventricular ejection fraction (OR 0.93, CI 0.86-0.99, p = 0.05), and peak VO2 (OR 0.78, CI 0.65-0.94, p = 0.008) were predictors of death. MNA-SF is an independent predictor of muscle wasting and mortality in ambulatory patients with HF. Nutritional screening should be included as a fundamental part of the overall assessment of these patients.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 058441955

Download citation: RISBibTeXText

PMID: 27853883

DOI: 10.1007/s00508-016-1112-8


Related references

Muscle wasting in patients with chronic heart failure: results from the studies investigating co-morbidities aggravating heart failure (SICA-HF). European Heart Journal 34(7): 512-519, 2013

C-terminal agrin-fragment as a novel diagnostic marker for muscle wasting in patients with chronic heart failure: results from the studies investigating co-morbidities aggravating heart failure. European Heart Journal 34(Suppl 1): P5077-P5077, 2013

Detection of muscle wasting in patients with chronic heart failure using C-terminal agrin fragment: results from the Studies Investigating Co-morbidities Aggravating Heart Failure (SICA-HF). European Journal of Heart Failure 17(12): 1283-1293, 2015

Resting energy expenditure and the effects of muscle wasting in patients with chronic heart failure: results from the Studies Investigating Comorbidities Aggravating Heart Failure (SICA-HF). Journal of the American Medical Directors Association 14(11): 837-841, 2013

Risk Factors of Anaemia-Development in Patients with Chronic Heart Failure: Results from the Studies Investigating Co-morbidities Aggravating Heart Failure (SICA-HF). Journal of Cardiac Failure 20(8): S38-S39, 2014

Anorexia, functional capacity, and clinical outcome in patients with chronic heart failure: results from the Studies Investigating Co-morbidities Aggravating Heart Failure (SICA-HF). Esc Heart Failure 4(4): 448-457, 2017

The impact of iron deficiency and anaemia on exercise capacity and outcomes in patients with chronic heart failure. Results from the Studies Investigating Co-morbidities Aggravating Heart Failure. International Journal of Cardiology 205: 6, 2016

Comparison of sarcopenia and cachexia in men with chronic heart failure: results from the Studies Investigating Co-morbidities Aggravating Heart Failure (SICA-HF). European Journal of Heart Failure 20(11): 1580-1587, 2018

Diabetes mellitus, cachexia and obesity in heart failure: rationale and design of the Studies Investigating Co-morbidities Aggravating Heart Failure (SICA-HF). Journal of Cachexia Sarcopenia and Muscle 1(2): 187-194, 2010

Impact of Plasma Kynurenine Level on Functional Capacity and Outcome in Heart Failure - Results From Studies Investigating Co-morbidities Aggravating Heart Failure (SICA-HF). Circulation Journal 81(1): 52-61, 2016

Sarcopenia and Endothelial Function in Patients With Chronic Heart Failure: Results From the Studies Investigating Comorbidities Aggravating Heart Failure (SICA-HF). Journal of the American Medical Directors Association 18(3): 240-245, 2017

Malnutrition, muscle wasting and cachexia in chronic heart failure: the nutritional approach. Italian Heart Journal 4(4): 232-235, 2003

Relationship of plasma galectin-3 to renal function in patients with heart failure: effects of clinical status, pathophysiology of heart failure, and presence or absence of heart failure. Journal of the American Heart Association 1(5): E000760, 2012

Effects of ghrelin administration on left ventricular function, exercise capacity, and muscle wasting in patients with chronic heart failure. Circulation 110(24): 3674-3679, 2004

Health Status Variation Across Practices in Outpatients With Heart Failure: Insights From the CHAMP-HF (Change the Management of Patients With Heart Failure) Registry. Circulation. Cardiovascular Quality and Outcomes 11(4): E004668, 2018