Metabolic frailty in malnourished heart failure patients

https://doi.org/10.4081/monaldi.2007.461

Authors

  • Alessandra Gualco Unità Operativa Riabilitativa Cardiologica, Istituto di Gussago Lumezzane (BS), Italy.
  • Cristina Opasich | copasich@fsm.it Unità Operativa Riabilitativa Cardiologica, Istituto di Gussago Lumezzane (BS), Italy.
  • Silvia Brazzo Unità Operativa Riabilitativa Cardiologica, Istituto di Gussago Lumezzane (BS), Italy.
  • Franco Cobelli Unità Operativa Riabilitativa Cardiologica, Istituto di Gussago Lumezzane (BS), Italy.
  • Evasio Pasini Unità Operativa Riabilitativa Cardiologica, Istituto di Gussago Lumezzane (BS), Italy.
  • Ornella Pastoris Dipartimento di Scienze Fisiologiche-Farmacologiche Cellulari-Molecolari, Sezione di Farmacologia e Biotecnologie Farmacologiche, Università degli Studi di Pavia, Italy.
  • Roberto Aquilani Servizio Mebabolico Nutrizionale, Istituto di Montescano (PV), Italy.

Abstract

Muscular wasting (MW) and cardiac cachexia (CC) are often present in patients with chronic heart failure (HF). Aim: To identify whether MW and CC are due to malnutrition or impairment of protein metabolism in HF patients. Material and Method: In 78 clinically stable HF patients (NYHA class II-III), aged from 32 to 89 years, we measured anthropometrical parameters and nutritional habits. In the identified 35 malnourished patients, we also measured: insulin resistance, gluconeogenetic amino acids blood concentration and nitrogen balance. Results: Seventy-five patients had eating-related symptoms. However we found significant nutritional impairment in 35 patients only. In addition, these 35 patients had: 1) significant increase of blood Alanine independently from both presence of insulin resistance or food intake reduction and 2) positive nitrogen balance. Conclusion: Food intake is not impaired in CHF patients. In spite of normal food intake, 35 of 78 patients had nutritional impairment with reduced anthropometric parameters and increased blood Alanine. These findings show alteration of proteins metabolism with proteolysis. We believe that specific physical training with nutritional supplement can be an additional therapy able to prevent protein disarrangement in CHF patients.

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Published
2016-02-01
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Original Articles
Keywords:
cachexia, muscle, nutrition, heart failure
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How to Cite
Gualco, Alessandra, Cristina Opasich, Silvia Brazzo, Franco Cobelli, Evasio Pasini, Ornella Pastoris, and Roberto Aquilani. 2016. “Metabolic Frailty in Malnourished Heart Failure Patients”. Monaldi Archives for Chest Disease 68 (2). https://doi.org/10.4081/monaldi.2007.461.

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