title: [Nutritional repercussion in advanced heart failure and its value in prognostic assessment].
abstract: OBJECTIVE
  To analyze the nutritional repercussion in heart failure and its relations with left ventricular dysfunction and mortality.
  
  
  METHODS
  A series of nutritional parameters in a group of 95 patients with advanced chronic heart failure, arising out of dilated cardiomyopathy and age < 65 years old, without concomitant diseases was studied. The duration of symptons, final diastolic diameter and left ventricular ejection fraction were verified. The nutritional assessment, included the ideal percentage of weight the triceps skin fold thickness, percentiles of circumference of muscular mass of the arm, the albumin serum levels and the lymphocytes global count.
  
  
  RESULTS
  The nutritional situation was alterated in 45.3% to 94.7% of the patients in accordance to the assessment parameter used. There was neither correlation between the nutritional parameters and the length of symptoms, nor with the ventricular dysfunction level. That group of patients had a homogenous evolution, and 75.8% of them died in an average time of 21.86 weeks. The left ventricular diastolic diameter and ejection fraction did not allow for the prediction of survival. A diminished body mass identified a group with higher risk of death. The ideal percentage of the body mass was predictive of survival (p=0.0352), the patients with less than 80% of ideal weight had a higher relative risk of death of 1.99 (1.12-3.02) (p=0.0132).
  
  
  CONCLUSIONS
  Malnutrition is frequent in patients with advanced heart failure and dilated cardiomyopathy. The reduced body mass was a better predictor of survival than the left ventricular ejection fraction in patients under advanced stage of myocardial compromising.
authors: Instituto do Coração do Hospital das Clínicas, FMUSP, São Paulo, Brazil.
authors: Luís Guilherme
authors: LG
authors: Veloso
authors: Mucio Tavares
authors: MT
authors: de Oliveira
authors: Robson Tadeu
authors: RT
authors: Munhoz
authors: Paulo Cesar
authors: PC
authors: Morgado
authors: José Antonio Franchini
authors: JA
authors: Ramires
authors: Antonio Carlos Pereira
authors: AC
authors: Barretto
mesh_terms: D000293:Adolescent; D000328:Adult; D000886:Anthropometry; D002908:Chronic Disease; D005260:Female; D006333:Heart Failure / Q000209:etiology / Q000401:mortality / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015596:Nutrition Assessment; D009752:Nutritional Status; D011379:Prognosis; D016019:Survival Analysis; D018487:Ventricular Dysfunction, Left / Q000150:complications / Q000401:mortality / Q000503:physiopathology*