Abstract
BACKGROUND: This study aimed to evaluate the effects of protein and amino acid supplementation on physical performance in patients with chronic heart failure (CHF). METHODS AND RESULTS: Studies from PubMed, the Cochrane Library, CINAHL, Web of Science, and PEDro published up to August 2024 were identified using a comprehensive strategy with no limitations on publication date or language. The primary outcome was physical performance, assessed using the 6-min walk distance (6MWD) test. This study included 15 randomized controlled trials involving a total of 744 patients. Control groups received either a placebo or usual care, including standard heart failure treatment. The meta-analysis demonstrated a significant improvement in 6MWD in the supplementation group compared with controls (mean difference 35.25 m; 95% confidence interval 15.93-54.58; I(2)=38%). Subgroup analysis showed no significant difference between supplementation alone and supplementation combined with exercise, suggesting independent effects. Patients aged ≥65 years showed similar benefits. CONCLUSIONS: Our meta-analysis indicated that physical performance in patients with CHF was improved by using protein and amino acid supplementation, particularly in older adults or those unable to engage in adequate exercise therapy. However, the overall quality of the evidence was very low.