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Nutritional strategy in the management of heart failure in adults

I Bourdel-Marchasson1, J P Emeriau

  • 1Centre de Gériatrie Henri Choussat, Hôpital Xavier Arnozan, Centre Hospitalo-Universitaire de Bordeaux, Bordeaux, France. isabelle.bourdel-marchasson@chu-bordeaux.fr

American Journal of Cardiovascular Drugs : Drugs, Devices, and Other Interventions
|January 20, 2004
PubMed

Insights

Congestive heart failure (CHF) patients often experience malnutrition, known as cardiac cachexia, which increases mortality. Nutritional support, especially perioperatively, shows promise, but long-term studies are needed for management recommendations.

Area of Science:

  • Cardiology
  • Nutrition Science
  • Metabolic Disorders

Background:

  • Congestive heart failure (CHF) incidence is rising globally, leading to reduced quality of life and increased mortality.
  • Malnutrition, termed cardiac cachexia, is prevalent in CHF patients and independently linked to higher mortality rates.
  • Cardiac cachexia is characterized by significant lean body mass loss, clinically defined by specific body weight reduction over time.

Purpose of the Study:

  • To explore the mechanisms of malnutrition in CHF patients.
  • To review the impact of malnutrition on functional capacity and mortality in CHF.
  • To evaluate potential therapeutic strategies, including nutritional interventions, for cardiac cachexia.

Main Methods:

  • Literature review of studies on CHF, malnutrition, and cardiac cachexia.
  • Analysis of neurohormonal alterations and cytokine release in CHF-related malnutrition.
  • Examination of the effects of malnutrition on skeletal muscle function and energy expenditure.

Main Results:

  • Energy requirements in CHF are not significantly altered, but anorexia can occur during decompensation.
  • Malnutrition impairs muscle function through decreased mass, strength, and altered fiber types.
  • Perioperative nutritional support in surgical CHF patients reduces mortality, suggesting potential benefits of nutritional interventions.

Conclusions:

  • Long-term nutritional supplementation trials are essential to establish evidence-based recommendations for managing malnutrition in CHF patients.
  • Understanding the neurohormonal and cytokine pathways is crucial for developing targeted therapies.
  • Further research is needed to confirm the efficacy of anabolic and anticytokine therapies for cardiac cachexia.

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