TY - JOUR
T1 - Adequate energy-protein intake is not enough to improve nutritional and metabolic status in muscle-depleted patients with chronic heart failure
AU - Aquilani, Roberto
AU - Opasich, Cristina
AU - Gualco, Alessandra
AU - Verri, Manuela
AU - Testa, Amidio
AU - Pasini, Evasio
AU - Viglio, Simona
AU - Iadarola, Paolo
AU - Pastoris, Ornella
AU - Dossena, Maurizia
AU - Boschi, Federica
PY - 2008/11
Y1 - 2008/11
N2 - Background: An adequate energy-protein intake (EPI) when combined with amino acid supplementation may have a positive impact on nutritional and metabolic status in patients with chronic heart failure (CHF). Methods and results: Thirty eight stable CHF patients (27 males, 73.5 ± 4 years; BMI 22.5 ± 1.4 kg/m2), with severe depletion of muscle mass and were randomised to oral supplements of essential amino acids 8 g/day (EAA group; n = 21) or no supplements (controls; n = 17). All patients had adequate EPI (energy ≥ 30 kcal/kg; proteins > 1.1 g/kg). At baseline and 2-months after randomisation, the patients underwent metabolic (plasma lactate, pyruvate concentration; serum insulin level; estimate of insulin resistance by HOMA index), nutritional (measure of nitrogen balance), and functional (exercise test, walking test) evaluations. Body weight increased by > 1 kg in 80% of supplemented patients (mean 2.96 kg) and in 30% of controls (mean 2.3 kg) (interaction <0.05). Changes in arm muscle area, nitrogen balance, and HOMA index were similar between the two treatment groups. Plasma lactate and pyruvate levels increased in controls (p <0.01 for both) but decreased in the supplemented group (p <0.01 and 0.02 respectively). EAA supplemented patients but not controls improved both exercise output and peak oxygen consumption and walking test. Conclusions: Adequate EPI when combined with essential amino acid supplementation may improve nutritional and metabolic status in most muscle-depleted CHF patients.
AB - Background: An adequate energy-protein intake (EPI) when combined with amino acid supplementation may have a positive impact on nutritional and metabolic status in patients with chronic heart failure (CHF). Methods and results: Thirty eight stable CHF patients (27 males, 73.5 ± 4 years; BMI 22.5 ± 1.4 kg/m2), with severe depletion of muscle mass and were randomised to oral supplements of essential amino acids 8 g/day (EAA group; n = 21) or no supplements (controls; n = 17). All patients had adequate EPI (energy ≥ 30 kcal/kg; proteins > 1.1 g/kg). At baseline and 2-months after randomisation, the patients underwent metabolic (plasma lactate, pyruvate concentration; serum insulin level; estimate of insulin resistance by HOMA index), nutritional (measure of nitrogen balance), and functional (exercise test, walking test) evaluations. Body weight increased by > 1 kg in 80% of supplemented patients (mean 2.96 kg) and in 30% of controls (mean 2.3 kg) (interaction <0.05). Changes in arm muscle area, nitrogen balance, and HOMA index were similar between the two treatment groups. Plasma lactate and pyruvate levels increased in controls (p <0.01 for both) but decreased in the supplemented group (p <0.01 and 0.02 respectively). EAA supplemented patients but not controls improved both exercise output and peak oxygen consumption and walking test. Conclusions: Adequate EPI when combined with essential amino acid supplementation may improve nutritional and metabolic status in most muscle-depleted CHF patients.
KW - Chronic heart failure
KW - Energy-protein intake
KW - Essential amino acids
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U2 - 10.1016/j.ejheart.2008.09.002
DO - 10.1016/j.ejheart.2008.09.002
M3 - Article
C2 - 18835539
AN - SCOPUS:54049102354
VL - 10
SP - 1127
EP - 1135
JO - European Journal of Heart Failure
JF - European Journal of Heart Failure
SN - 1388-9842
IS - 11
ER -