title: Geriatric nutritional risk index predicts functional dependency and mortality in patients with heart failure with preserved ejection fraction.
abstract: BACKGROUND
  The clinical significance of nutritional risk assessment in patients with heart failure with preserved ejection fraction (HFpEF) remains undefined. Geriatric nutritional risk index (GNRI) is a simple nutritional assessment tool for elderly subjects. Its predictive value was evaluated in patients with HFpEF, a common HF phenotype in the elderly population.
  
  
  RESULTS
  The present study enrolled 152 consecutive patients (mean age, 77 ± 11 years; male, 53.9%) who were hospitalized with HFpEF at the authors' institution. GNRI on admission was calculated as follows: 14.89 × serum albumin (g/dl)+41.7×body mass index/22. Characteristics and mortality (median follow-up of 2.1 years) were compared between 2 groups: low GNRI (<92) with moderate or severe nutritional risk; and high GNRI (≥ 92) with no or low nutritional risk. Patients in the low-GNRI group were more often female, and had lower serum hemoglobin and sodium, but higher serum blood urea nitrogen (BUN), C-reactive protein, and B-type natriuretic peptide (BNP) compared to those in the high-GNRI group (P<0.05, respectively). Physical activity at discharge measured by Barthel index was significantly lower in the low-GNRI group than the high-GNRI group (P<0.05). On Cox hazard analysis, lower GNRI predicted increased mortality independent of age, gender, prior HF hospitalization, and higher BUN and BNP (P<0.01).
  
  
  CONCLUSIONS
  GNRI may be useful for predicting functional dependency and mortality in patients with HFpEF.
authors.affiliation: Division of Cardiovascular Medicine, Department of Molecular Medicine and Therapeutics, Faculty of Medicine, Tottori University, Yonago, Japan. ykinugasa-circ@umin.ac.jp
authors.forename: Yoshiharu
authors.initials: Y
authors.lastname: Kinugasa
authors.forename: Masahiko
authors.initials: M
authors.lastname: Kato
authors.forename: Shinobu
authors.initials: S
authors.lastname: Sugihara
authors.forename: Masayuki
authors.initials: M
authors.lastname: Hirai
authors.forename: Kensaku
authors.initials: K
authors.lastname: Yamada
authors.forename: Kiyotaka
authors.initials: K
authors.lastname: Yanagihara
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Yamamoto
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D001806:Blood Urea Nitrogen; D002097:C-Reactive Protein / Q000378:metabolism; D005260:Female; D005500:Follow-Up Studies; D015577:Geriatric Assessment; D006333:Heart Failure / Q000097:blood / Q000401:mortality* / Q000503:physiopathology*; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood; D015596:Nutrition Assessment; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D018570:Risk Assessment; D012737:Sex Factors; D013318:Stroke Volume / Q000502:physiology*; D015996:Survival Rate
chemical_list: D006454:Hemoglobins; D020097:Natriuretic Peptide, Brain; D002097:C-Reactive Protein