Effectiveness of high-energy, high-protein nutritional supplementation on patients with chronic heart failure and malnutrition: A pilot open-label randomized trial

高能量、高蛋白营养补充剂对慢性心力衰竭合并营养不良患者的疗效:一项开放标签随机对照试验

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Abstract

Malnutrition is a common problem in patients with chronic heart failure, affecting the prognosis of readmission and mortality. The aim of this study is to evaluate the effects of high-energy, high-protein nutritional supplementation on hospitalized patients with chronic heart failure combined with malnutrition. A randomized, open-label, controlled clinical study was performed from October 2020 to May 2022 at the Department of Cardiology, Cho Ray Hospital. Forty patients were randomly selected for the intervention (diet with high-energy, high-protein nutritional supplementation) and control groups (normal diet). Of the 40 patients included in this study, 21 were randomized into the intervention group and 19 into the control group. The mean age of participants was 65.53 ± 19.20 years; 24 (60%), 14 (35%), and 2 (5%) patients were classed as New York Heart Association grade II, grade III, and grade IV, respectively. The prevalence of malnutrition at admission was 65% based on body mass index (BMI) and 80% based on the subjective global assessment. The rates of severe malnutrition in the control and the intervention groups were 21.1% and 38.1%, respectively, based on BMI, and 84.21% and 76.19% based on subjective global assessment. The intervention group had an actual total energy intake of 1560.80 ± 80.32 kcal, higher than the recommended intake of 1377.54 ± 69.27 kcal (P = .03). Following the nutritional intervention, weight, BMI, phase angle, handgrip strength, and serum prealbumin significantly increased in the intervention group. None of the patients in either group developed symptoms of gastrointestinal intolerance. The mean hospital stay was 7.15 ± 1.38 days, with no statistically significant difference between the intervention and control groups. High-energy, high-protein oral nutritional supplementation helps improve nutritional status for patients hospitalized with chronic heart failure, as shown by changes in body weight, BMI, phase angle, handgrip strength, and serum prealbumin. Furthermore, this nutrition regimen was well-tolerated, and no gastrointestinal adverse events were observed.

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