Document Detail


Adequate energy-protein intake is not enough to improve nutritional and metabolic status in muscle-depleted patients with chronic heart failure.
MedLine Citation:
PMID:  18835539     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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> or =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.
Authors:
Roberto Aquilani; Cristina Opasich; Alessandra Gualco; Manuela Verri; Amidio Testa; Evasio Pasini; Simona Viglio; Paolo Iadarola; Ornella Pastoris; Maurizia Dossena; Federica Boschi
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial     Date:  2008-10-04
Journal Detail:
Title:  European journal of heart failure     Volume:  10     ISSN:  1388-9842     ISO Abbreviation:  Eur. J. Heart Fail.     Publication Date:  2008 Nov 
Date Detail:
Created Date:  2008-12-23     Completed Date:  2009-02-03     Revised Date:  2011-06-08    
Medline Journal Info:
Nlm Unique ID:  100887595     Medline TA:  Eur J Heart Fail     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  1127-35     Citation Subset:  IM    
Affiliation:
Servizio di Fisiopatologia Metabolico-Nutrizionale e Nutrizione Clinica, Fondazione S. Maugeri, IRCCS, Istituto Scientifico di Montescano, Montescano-Pavia, Italy.
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MeSH Terms
Descriptor/Qualifier:
Administration, Oral
Aged
Aged, 80 and over
Amino Acids, Essential / administration & dosage*
Body Mass Index
Body Weight / physiology
Chronic Disease
Dietary Proteins / administration & dosage*
Energy Metabolism / physiology*
Exercise Test
Female
Follow-Up Studies
Heart Failure / diet therapy*,  metabolism,  physiopathology
Humans
Insulin / blood
Lactates / blood
Male
Middle Aged
Nutritional Status / physiology*
Pyruvates / blood
Time Factors
Treatment Outcome
Chemical
Reg. No./Substance:
0/Amino Acids, Essential; 0/Dietary Proteins; 0/Lactates; 0/Pyruvates; 11061-68-0/Insulin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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