[Metabolic frailty in malnourished heart failure patients].
Muscular wasting (MW) and cardiac cachexia (CC) are often present in patients with chronic heart failure (HF).


OBJECTIVE
To identify whether MW and CC are due to malnutrition or impairment of protein metabolism in HF patients.


METHODS
In 78 clinically stable HF patients (NYHA class II-III), aged from 32 to 89 years, we measured anthropometrical parameters and nutritional habits. In the identified 35 malnourished patients, we also measured: insulin resistance, gluconeogenetic amino acids blood concentration and nitrogen balance.


RESULTS
Seventy-five patients had eating-related symptoms. However we found significant nutritional impairment in 35 patients only. In addition, these 35 patients had: 1) significant increase of blood Alanine independently from both presence of insulin resistance or food intake reduction and 2) positive nitrogen balance.


CONCLUSIONS
Food intake is not impaired in CHF patients. In spite of normal food intake, 35 of 78 patients had nutritional impairment with reduced anthropometric parameters and increased blood Alanine. These findings show alteration of proteins metabolism with proteolysis. We believe that specific physical training with nutritional supplement can be an additional therapy able to prevent protein disarrangement in CHF patients.
Gualco
Alessandra
A
Fondazione Salvatore Maugeri, Istituto di Ricovero e Cura a Carattere Scientifico, Unità Operativa Riabilitativa Cardiologica, Istituto di Pavia, Italy.
Opasich
Cristina
C
Brazzo
Silvia
S
Cobelli
Franco
F
Pasini
Evasio
E
Pastoris
Ornella
O
Aquilani
Roberto
R
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002100:Cachexia / Q000503:physiopathology*; D005260:Female; D006333:Heart Failure / Q000503:physiopathology*; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000503:physiopathology*; D008875:Middle Aged; D019282:Wasting Syndrome / Q000503:physiopathology*