title: [Metabolic frailty in malnourished heart failure patients].
abstract: 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.
authors: Fondazione Salvatore Maugeri, Istituto di Ricovero e Cura a Carattere Scientifico, Unità Operativa Riabilitativa Cardiologica, Istituto di Pavia, Italy.
authors: Alessandra
authors: A
authors: Gualco
authors: Cristina
authors: C
authors: Opasich
authors: Silvia
authors: S
authors: Brazzo
authors: Franco
authors: F
authors: Cobelli
authors: Evasio
authors: E
authors: Pasini
authors: Ornella
authors: O
authors: Pastoris
authors: Roberto
authors: R
authors: Aquilani
mesh_terms: 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*