[Effect of enteral feeding on exercise tolerance and clinical picture in patients with NYHA class III-IV chronic heart failure].
OBJECTIVE
To elucidate efficacy of enteral feeding and the role of small intestine in pathogenesis of cardiac cachexia in patients with heart failure and reduced body mass.


METHODS
Patients with NYHA class III-IV chronic heart failure and deficient body mass (n=34). Control group comprised 32 patients.


METHODS
In intervention group standard therapy was supplemented for 24 weeks with balanced nutritional mixture constituting 25% of daily energy requirements. Efficacy of treatment was assessed by 6 minute walk test, evaluation of lean body mass. Studies of intestinal functional activity and biopsies of small intestinal mucosa with morphometrical analysis of bioptates were also performed.


RESULTS
Results of 6-minute walk test improved in intervention and control groups by 46.8 and 10.3%, respectively. Average lean body mass increased in intervention group (by 6.7%) and decreased in controls (by 4.9%, p=0.03). Morphometrical study of bioptates revealed augmentation of relative collagen area up to 35-37% (normal value - 10-15%) and pronounced villus atrophy.
Arutiunov
G P
GP
Kostiukevich
O I
OI
Rylova
N V
NV
Voevodina
N Iu
NIu
Korsunskaia
M I
MI
D000368:Aged; D001284:Atrophy; D001706:Biopsy; D015992:Body Mass Index; D002100:Cachexia / Q000209:etiology / Q000517:prevention & control; D002149:Energy Intake; D004750:Enteral Nutrition; D015444:Exercise; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000473:pathology / Q000628:therapy*; D006801:Humans; D007413:Intestinal Mucosa / Q000473:pathology; D007421:Intestine, Small / Q000473:pathology; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D016138:Walking