早期心力衰竭和保留射血分数患者营养不良风险的患病率、病理生理学和预后重要性。

IF 3.1 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
Yuta Tani, Naoki Yuasa, Tomonari Harada, Kazuki Kagami, Fumitaka Murakami, Yuki Shimoya, Yuki Saito, Ayami Naito, Tsukasa Murakami, Takahiro Okuno, Tomoaki Ishii, Toshimitsu Kato, Naoki Wada, Shigeru Usuda, Hideki Ishii, Masaru Obokata
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引用次数: 0

摘要

背景和目的:在临床表现明显的心力衰竭和保留射血分数(HFpEF)患者中,营养不良是常见的,并且与不良的临床预后相关。然而,其在早期HFpEF中的患病率、病理生理和预后相关性尚不清楚。本研究旨在评估早期HFpEF患者(定义为无HF住院史的患者)营养不良风险、运动能力、心脏和外周储备限制与临床结果之间的关系。方法:无HF住院史的症状性HFpEF患者(n=341)行运动应激超声心动图检查。同时对296名(87%)参与者进行了过期气体分析,以测量峰值耗氧量(vo2)。采用老年营养风险指数(GNRI)评估营养状况。结果:125例(36.6%)HFpEF患者存在至少轻度营养不良风险(GNRI≤98)。与没有营养不良风险的HFpEF患者(n=216)相比,有营养不良风险的患者(n=125)在运动过程中表现出运动能力降低(VO 2峰值降低)、心输出量和动静脉氧含量差值降低。在中位435天的随访期间,52例患者出现了全因死亡或心衰事件恶化的复合结局。与没有风险的患者相比,有营养不良风险的患者发生这种结果的风险增加了近3倍(风险比,3.07;95%置信区间为1.73-5.44;结论:营养不良风险在早期HFpEF中很常见,并与运动不耐受、心输出量和摄氧量减少以及较差的预后相关。需要进一步的研究来确定管理策略。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Prevalence, Pathophysiology, and Prognostic Importance of Malnutrition Risk in Early-Stage Patients With Heart Failure and Preserved Ejection Fraction.

Background and objectives: Malnutrition is common and is associated with poor clinical outcomes in clinically overt patients with heart failure and preserved ejection fraction (HFpEF). However, its prevalence and pathophysiologic and prognostic relevance remain unclear in early-stage HFpEF. This study sought to assess the association between malnutrition risk, exercise capacity, cardiac and peripheral reserve limitations, and clinical outcomes in patients with early HFpEF, defined as those without a history of HF hospitalization.

Methods: Patients with symptomatic HFpEF without previous HF hospitalization (n=341) underwent exercise stress echocardiography. Simultaneous expired gas analysis was conducted in 296 (87%) participants to measure peak oxygen consumption (VO₂). Nutritional status was evaluated using the Geriatric Nutritional Risk Index (GNRI).

Results: At least mild malnutrition risk (GNRI ≤98) was identified in 125 patients with HFpEF (36.6%). Compared to HFpEF patients without malnutrition risk (n=216), those at risk (n=125) showed reduced exercise capacity (lower peak VO₂) and lower cardiac output and arteriovenous oxygen content difference during exercise. During a median follow-up of 435 days, 52 patients experienced a composite outcome of all-cause mortality or worsening HF events. Patients with malnutrition risk had a nearly 3-fold increased risk of this outcome compared to those without risk (hazard ratio, 3.07; 95% confidence interval, 1.73-5.44; p<0.001).

Conclusions: Malnutrition risk is common in early-stage HFpEF and correlates with exercise intolerance, reduced cardiac output and oxygen uptake, and worse outcomes. Further research is needed to determine management strategies.

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来源期刊
Korean Circulation Journal
Korean Circulation Journal CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
4.90
自引率
17.20%
发文量
103
期刊介绍: Korean Circulation Journal is the official journal of the Korean Society of Cardiology, the Korean Pediatric Heart Society, the Korean Society of Interventional Cardiology, and the Korean Society of Heart Failure. Abbreviated title is ''Korean Circ J''. Korean Circulation Journal, established in 1971, is a professional, peer-reviewed journal covering all aspects of cardiovascular medicine, including original articles of basic research and clinical findings, review articles, editorials, images in cardiovascular medicine, and letters to the editor. Korean Circulation Journal is published monthly in English and publishes scientific and state-of-the-art clinical articles aimed at improving human health in general and contributing to the treatment and prevention of cardiovascular diseases in particular. The journal is published on the official website (https://e-kcj.org). It is indexed in PubMed, PubMed Central, Science Citation Index Expanded (SCIE, Web of Science), Scopus, EMBASE, Chemical Abstracts Service (CAS), Google Scholar, KoreaMed, KoreaMed Synapse and KoMCI, and easily available to wide international researchers
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