[Heart failure, malnutrition and inflammation. Prevalence and relevant aspects in its assessment].
Heart failure is associated to alterations in the nutritional status that contributes to a worse prognosis of the disease.


OBJECTIVE
To study protein-calorie malnutrition (PEM) prevalence, micronutrient deficits and increase of inflammatory parameters in patients with cardiac failure (CF).


METHODS
Cross-sectional, observational study in 98 heart failure patients of Internal Medicine Service have been evaluated. We have analyzed biomedical, anthropometric variables (weight, size, BMI, tricipital fold), search of treatments, echocardiogram valuation and determination of albumin, pre-albumin, A and E group vitamins, ESR and C-reactive protein. We have defined protein malnutrition (PN) as albumin values


RESULTS
Average age was 76.6 +/- 7.5. A total of 77.7% showed a functional class II-III/IV. Prevalence of PEM was 40%. Low albumin and prealbumin was found in 12.8% and 38.3% respectively (p < 0.05). Using BMI, 5.3% of patients had malnutrition. Nevertheless, if tricipital fold is used, EM was found in the 25.3% of the cases (p < 0.05). Iron iron, vitamin A and C-reactive protein levels were different in heart failure patients with PM (p < 0.05). The percentage of protein malnutrition in patients with LVEF < 45% was 16.4% versus 5.5% in diastolic dysfunction (p = 0.01). Treatment with ACE-inhibitors was 42.2%; in this group the malnutrition for any criterion was 13% vs 26% in the group of patients without ACE-inhibitors (p = 0.08).


CONCLUSIONS
There is a high prevalence of nutritional and inflammatory disturbances (low in diastolic dysfunction) in patients with moderate status of heart failure. Treatment with an ACE-inhibitor improves the nutritional parameters.
Agudo de Blas
P
P
Departamento de Medicina Interna, Hospital General Universitario Gregorio Marañón, Madrid, Spain. pagudomaiza@yahoo.com
Conthe Gutiérrez
P
P
Alvarez de Frutos
V
V
García Peris
P
P
Gil López
M
M
Torres Segovia
F J
FJ
D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D006333:Heart Failure / Q000503:physiopathology*; D006801:Humans; D007249:Inflammation / Q000209:etiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011502:Protein-Energy Malnutrition / Q000453:epidemiology / Q000209:etiology*