• Medicina clinica · Oct 2021

    Prognostic value of malnutrition in patients with acute heart failure and its influence on the interpretation of markers of systemic venous congestion.

    • Jorge Rubio-Gracia, Claudia Josa-Laorden, Marta Sánchez-Marteles, Ignacio Giménez-López, Vanesa Garcés Horna, José Luis Morales Rull, and Juan Ignacio Pérez-Calvo.
    • Servicio de Medicina Interna, Hospital Clínico Universitario «Lozano Blesa», Zaragoza, España; Instituto de Investigación Sanitaria de Aragón (IIS), Zaragoza, España. Electronic address: jorgerubiogracia@gmail.com.
    • Med Clin (Barc). 2021 Oct 22; 157 (8): 371-379.

    BackgroundMalnutrition is frequent in patients with heart failure (HF) and contributes to increased systemic congestion, but also hinders its correct assessment, especially during decompensations. Estimating the degree of malnutrition and its relationship with systemic congestion is important to optimize treatment during decompensations.Material And MethodsRetrospective cohort study in patients with acute HF. The population was stratified according to CONUT (Controlling Nutritional Status) and PNI (Prognostic Nutritional Index) nutrition indices in order to analyse their relationship with objective parameters of congestion and the prognostic value of malnutrition.Results309 patients were included. More than half presented some degree of malnutrition upon admission. The degree of congestion was significantly higher in malnourished patients, with a higher proportion of «comet tail artifacts» and a higher relative plasma volume. NT-proBNP concentrations, both on admission and at discharge, were also significantly higher in malnourished patients, regardless of the scale used. The univariate analysis identified the CONUT and PNI index as factors associated with one-year mortality from any cause (HR 1.62 [1.22-2.14]; p = 0.001) and PNI (HR 65 [0.53-0.80]; p = < 0.001), respectively.ConclusionsA higher degree of malnutrition (determined by means of the CONUT and PNI indices) in patients with acute HF was associated with a higher presence of objective parameters of congestion and a higher one-year all-cause mortality.Copyright © 2020 Elsevier España, S.L.U. All rights reserved.

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