Major considerations of cardiometabolic nutrients in heart failure: a systematic review

Introduction: Heart failure (HF) is one of the main causes of hospitalizations in the world. In Brazil, about 7.0 million Brazilians suffer from this syndrome. The clinical evolution of patients with HF evidence variable conditions of malnutrition. This can occur due to inadequate intake, altered metabolism, pro-inflammatory state, increased oxidative stress, and greater loss of nutrients, even due to drug interactions. Objective: It was to demonstrate, through a systematic review of the literature, the main considerations of cardiometabolic nutrients in heart failure. Methods: The present study followed a concise systematic review model (PRISMA). The literary search process was carried out from April to May 2023 and was developed based on Scopus, PubMed, Science Direct, Scielo, and Google Scholar, using scientific articles until 2023. The low quality of evidence was attributed to case reports, editorials, and short communications, according to the GRADE instrument. The risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 136 studies were found for eligibility analysis, and so 75 of a total of 84 studies were selected for this systematic review. According to the GRADE instrument, most studies showed homogeneity in their results, with X2 =92.2% >50%. The Funnel Plot showed a symmetrical behavior, not suggesting a significant risk of bias in studies with smaller sample sizes. The presence of malnutrition is an important predictive factor for reduced survival in patients with HF, highlighting inadequate food intake, altered metabolism, pro-inflammatory state, increased oxidative stress, greater loss of nutrients, and drug interactions. Patients with HF have anabolism/catabolism imbalance. Providing nutritional support significantly increased dietary adherence above 90%. Therefore, malnutrition and inflammation are important predictors for assessing the prognosis of the disease in patients with HF.