Abstract 2995: Undernutrition is an Important Prognostic Factor of Cardiac Death in Patients With Diastolic Heart Failure
Background: Wasting in chronic heart failure (CHF) is known as cardiac cachexia, which occurs in some patients with reduced systolic function. However, it remains to be examined whether the nutritional status also is associated with poor outcome of patients with diastolic heart failure (DHF).
Methods: In our cohort study with a total of 1278 patients with CHF, 263 consecutive patients with DHF (68±14 [SD] years, male 59%), defined by the Framingham criteria (history of CHF with LV ejection fraction (LVEF) ≥50%), were prospectively followed-up for 45±19 months. At the enrollment, their nutritional status was assessed by the CONUT score, a widely used nutritional status score representing the combined impact of serum albumin, total cholesterol level, and total lymphocyte count.
Results: Mean LVEF obtained by echocardiography was 63±10% at the enrollment, and 85% of the patients showed mild to moderate CHF symptoms (NYHA functional class I or II). In the follow-up period, 34 cardiac deaths (sudden death in 13 and CHF death in 21) and 37 non-cardiac deaths were observed. The Kaplan-Meier analysis revealed that among the 263 patients with DHF, both cardiac and non-cardiac deaths occurred more frequently in patients with undernutrition (CONUT score≥2) than in those with normal nutrition (CONUT score=0 or 1) (Figure⇓). Importantly, multivariate Cox regression analysis showed that undernutrition is an independent predictor for cardiac death (HR: 2.8, 95%CI: 1.2– 6.5) but not for non-cardiac death (HR: 1.3, 95%CI: 0.6 –2.8).
Conclusions: These results suggest that undernutrition is an important prognostic factor for cardiac death in patients with DHF.