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Association between nutritional status and heart failure with improved ejection fraction.
Guanzhong Chen1, Chengchen Zhao1, Yu Jin2
1Department of Cardiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310009, China; State Key Laboratory of Transvascular Implantation Devices, Hangzhou, Zhejiang, 310009, China.
Nutrition, Metabolism, and Cardiovascular Diseases : NMCD
|April 22, 2025
Summary
Malnutrition is linked to improved ejection fraction in heart failure patients. Assessing nutritional status may help predict this improvement in heart failure with reduced ejection fraction (HFrEF).
Area of Science:
- Cardiology
- Nutritional Science
- Internal Medicine
Background:
- A subset of patients with heart failure with reduced ejection fraction (HFrEF) can achieve improved ejection fraction (HFimpEF).
- Malnutrition is prevalent in heart failure and linked to worse outcomes.
- The relationship between nutritional status and HFimpEF is not well understood.
Purpose of the Study:
- To investigate the association between nutritional status and the development of HFimpEF in hospitalized HFrEF patients.
- To determine if nutritional indices can predict HFimpEF.
Main Methods:
- Retrospective analysis of 1057 hospitalized HFrEF patients.
- Patients classified as HFimpEF (follow-up EF >40% and ≥10% absolute increase) or persistent HFrEF.
- Nutritional status assessed using Prognostic Nutritional Index (PNI), Geriatric Nutritional Risk Index (GNRI), and Controlling Nutritional Status (CONUT) index. Logistic regression and restricted cubic splines used for analysis.
Main Results:
- 418 patients (39.55%) developed HFimpEF.
- Increased PNI, GNRI, and CONUT scores were significantly associated with HFimpEF after multivariate adjustment.
- CONUT score addition significantly improved prediction models for HFimpEF (AUC=0.698).
Conclusions:
- Malnutrition is associated with a lower likelihood of developing HFimpEF.
- Nutritional status assessment, particularly using the CONUT score, offers incremental predictive value for HFimpEF in HFrEF patients.
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