Nutrition markers in patients after heart surgery.
BACKGROUND
Nutrition support is an important aspect of multidisciplinary approaches in cardiology rehabilitation. However, little is known about the impact of a patient's nutrition status on recovery after elective heart surgery. The authors assessed changes in nutrition markers in patients undergoing postsurgical rehabilitation, and tested their correlation with systemic inflammatory responses and clinical outcomes to determine the adequacy of the prescribed dietary regimen.


METHODS
Plasma concentrations of nutrition biomarkers were measured in 50 nondiabetic patients upon admission to a cardiology rehabilitation unit after coronary artery bypass grafting or mitral and/or aortic valve replacement (D0), and again 16 days later (D16).


RESULTS
On D16, low plasma albumin increased, anemia improved, and high levels of inflammation markers declined. Vitamins remained stable within normal values, with the exception of vitamin B12, which decreased significantly from 516 +/- 341 to 445 +/- 212 ng/mL (P = .007). Blood glucose was >110 mg/dL in 51% of the patients at baseline; this proportion did not decline after rehabilitation. Overweight patients (body mass index >25 kg/m(2)) were prevalent (58%). They showed a slightly but not significantly greater inflammatory response and had a higher incidence of infective complications than the normal-weight group, but similar levels of nutrition markers.


CONCLUSIONS
The standard dietary regimen followed during cardiological rehabilitation after major cardiovascular surgery aids recovery from surgical insult, but fails to normalize high glucose levels. Vitamin B12 supplementation should be encouraged because of its substantial reduction during the rehabilitation period.
Racca
Vittorio
V
Unità Operativa Cardiologia Riabilitativa, IRCCS "Santa Maria Nascente" Fondazione Don C. Gnocchi, Milan, Italy. vracca@dongnocchi.it
Castiglioni
Paolo
P
Ripamonti
Vittorino
V
Bertoli
Simona
S
Calvo
Maria Gaetana
MG
Ferratini
Maurizio
M
D000368:Aged; D000740:Anemia / Q000097:blood* / Q000209:etiology; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D001026:Coronary Artery Bypass; D004032:Diet / Q000592:standards*; D005260:Female; D006331:Heart Diseases / Q000097:blood* / Q000150:complications / Q000601:surgery; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D006943:Hyperglycemia / Q000097:blood / Q000209:etiology; D007249:Inflammation / Q000097:blood* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D018529:Nutritional Support; D050177:Overweight / Q000097:blood / Q000150:complications; D011183:Postoperative Complications / Q000097:blood*; D012709:Serum Albumin / Q000378:metabolism*; D014805:Vitamin B 12 / Q000097:blood / Q000627:therapeutic use; D014815:Vitamins / Q000097:blood / Q000627:therapeutic use
D015415:Biomarkers; D001786:Blood Glucose; D012709:Serum Albumin; D014815:Vitamins; D014805:Vitamin B 12