Clinical, Metabolic, and Behavioral Correlates of Nutritional Status in Chronic Heart Failure

慢性心力衰竭患者营养状况的临床、代谢和行为相关性

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Abstract

Background: Heart failure (HF) is a chronic condition associated with frequent hospitalizations and impaired quality of life. Malnutrition is common in HF and is linked to adverse clinical outcomes, while self-care is an important component of HF management. This study aimed to examine the associations between nutritional status, self-care behaviors, and clinical characteristics in patients with chronic HF. Methods: A cross-sectional study was conducted among 100 hospitalized HF patients (mean age 75.9 ± 9.8 years; 63% men). Nutritional status was assessed using the Mini Nutritional Assessment (MNA), and self-care using the nine-item European Heart Failure Self-care Behaviour Scale (9-EHFScBS). Clinical variables included NYHA class, LVEF, comorbidities, BMI, and laboratory parameters. Comparative analyses and multivariate linear regression were performed. Results: Patients who were malnourished or at risk of malnutrition had significantly higher NT-proBNP levels (p = 0.004) and higher NYHA class (p = 0.002), whereas well-nourished individuals had significantly higher triglyceride levels (p = 0.032). Nutritional status was negatively associated with NYHA class and NT-proBNP, and positively associated with BMI. Among laboratory parameters, significant positive correlations were observed with hemoglobin, hematocrit, albumin, and triglyceride levels. In multivariate analysis, the following variables were independently associated with MNA score: self-care score (B = 0.083 per point), BMI (B = 0.368 per kg/m(2)), comorbidity burden (B = −0.401 per comorbidity), and NYHA class (NYHA III: B = −2.425; NYHA IV: B = −5.966, vs. NYHA II). Conclusions: In patients with chronic heart failure, nutritional status is associated with disease severity, metabolic parameters, comorbidity burden, BMI, and self-care behaviors. These findings support the importance of routine nutritional screening as part of comprehensive HF management.

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