Adequate energy-protein intake is not enough to improve nutritional and metabolic status in muscle-depleted patients with chronic heart failure

Roberto Aquilani, Cristina Opasich, Alessandra Gualco, Manuela Verri, Amidio Testa, Evasio Pasini, Simona Viglio, Paolo Iadarola, Ornella Pastoris, Maurizia Dossena, Federica Boschi

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish
Pages (from-to)1127-1135
Number of pages9
JournalEuropean Journal of Heart Failure
Volume10
Issue number11
DOIs
Publication statusPublished - Nov 2008

Fingerprint

Energy Intake
Nutritional Status
Heart Failure
Muscles
Proteins
Essential Amino Acids
Pyruvic Acid
Walking
Lactic Acid
Nitrogen
Nutrition Assessment
Random Allocation
Exercise Test
Oxygen Consumption
Insulin Resistance
Body Weight
Exercise
Insulin
Amino Acids
Serum

Keywords

  • Chronic heart failure
  • Energy-protein intake
  • Essential amino acids

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Adequate energy-protein intake is not enough to improve nutritional and metabolic status in muscle-depleted patients with chronic heart failure. / Aquilani, Roberto; Opasich, Cristina; Gualco, Alessandra; Verri, Manuela; Testa, Amidio; Pasini, Evasio; Viglio, Simona; Iadarola, Paolo; Pastoris, Ornella; Dossena, Maurizia; Boschi, Federica.

In: European Journal of Heart Failure, Vol. 10, No. 11, 11.2008, p. 1127-1135.

Research output: Contribution to journalArticle

Aquilani, Roberto ; Opasich, Cristina ; Gualco, Alessandra ; Verri, Manuela ; Testa, Amidio ; Pasini, Evasio ; Viglio, Simona ; Iadarola, Paolo ; Pastoris, Ornella ; Dossena, Maurizia ; Boschi, Federica. / Adequate energy-protein intake is not enough to improve nutritional and metabolic status in muscle-depleted patients with chronic heart failure. In: European Journal of Heart Failure. 2008 ; Vol. 10, No. 11. pp. 1127-1135.
@article{7dfe9637ee54455e8452efc2880c16bf,
title = "Adequate energy-protein intake is not enough to improve nutritional and metabolic status in muscle-depleted patients with chronic heart failure",
abstract = "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.",
keywords = "Chronic heart failure, Energy-protein intake, Essential amino acids",
author = "Roberto Aquilani and Cristina Opasich and Alessandra Gualco and Manuela Verri and Amidio Testa and Evasio Pasini and Simona Viglio and Paolo Iadarola and Ornella Pastoris and Maurizia Dossena and Federica Boschi",
year = "2008",
month = "11",
doi = "10.1016/j.ejheart.2008.09.002",
language = "English",
volume = "10",
pages = "1127--1135",
journal = "European Journal of Heart Failure",
issn = "1388-9842",
publisher = "John Wiley & Sons, Ltd",
number = "11",

}

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

UR - http://www.scopus.com/inward/record.url?scp=54049102354&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=54049102354&partnerID=8YFLogxK

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 -