Is there an association between the nutritional and functional parameters and congestive heart failure severity?

• Published in: Clinical nutrition (Edinburgh, Scotland) Scotland), 2021-05, Vol.40 (5), p.3354-3359
• Main Authors: Duarte, Rodrigo R.P., Gonzalez, M. Cristina, Oliveira, Jacqueline F., Goulart, Maíra Ribas, Castro, Iran
• Format: Article
• Language: English
• Subjects: Adductor pollicis muscle thickness; Handgrip strength; Heart failure; Malnutrition; Nutritional assessment
• ISSN: 0261-5614; 1532-1983
• DOI: 10.1016/j.clnu.2020.11.008

The association between markers of nutritional status (handgrip strength [HGS] and adductor pollicis muscle thickness [APMT]) and clinical markers of congestive heart failure (CHF) severity is currently unclear. The objective of this study was to evaluate the association between HGS, APMT, as markers of nutritional status and CHF severity. APMT and muscle strength was measured in 500 CHF patients bilaterally. Nutritional status was assessed by Subjective Global Assessment (SGA). Functional classification was performed according to guidelines provided by the New York Heart Association (NYHA) and ejection fraction (EF) was measured to classify CHF severity. Poisson regression, adjusted for sex and age, was performed to verify the association between nutritional factors and CHF severity markers. The majority of patients (75.8%) were ≥60 years old and 53.6% were either overweight or obese. SGA identified 42.2% of the patients as malnourished, 12.6% with low APMT, and 29.0% with low HGS. Most of the patients were classified as NYHA III/IV (56.8%) and almost one third of patients (31.1%) had EF ≤ 40%. HGS and APMT were significantly lower in malnourished male patients and in male patients with a lower EF or worse NYHA classification. Even after controlling for the EF, malnourished patients showed a 2.5-fold increased risk of CHF severity by NYHA classification and for each kilogram of increase in the HGS, there was a significant decrease of 2% in the risk (RR: 0.98 p