Appetite And Nutritional Status As Potential Management Targets In Patients With Heart Failure With Reduced Ejection Fraction-The Relationship Between Echocardiographic And Biochemical Parameters And Appetite

This study aimed to investigate the role of appetite loss and malnutrition in patients with heart failure with reduced ejection fraction (HFrEF). In this prospective, observational, single-center study, we enrolled 120 consecutive adults with HFrEF. We analyzed the selected clinical, echocardiographic, and biochemical parameters. Appetite loss and malnutrition were assessed by CNAQ (Council on Nutrition Appetite Questionnaire) and MNA (Mini Nutritional Assessment)/GNRI (Geriatric Nutritional Risk Index) questionnaires, respectively.Most patients were men (81.7%), mean age was 55.1 +/- 11.3 years, and mean left ventricular ejection fraction was 23.9 +/- 8.0%. The mean CNAQ score was 28.8 +/- 3.9, mean MNA-23.1 +/- 2.6, and mean GNRI-113.0 +/- 12.3. Based on ROC curves, we showed that a sodium concentration <138 mmol/L had the greatest discriminating power for diagnosing impaired nutritional status (MNA <= 23.5) with a sensitivity of 54.5% and specificity of 77.8%. The threshold of HDL <0.97 mmol/L characterized 40.7% sensitivity and 86% specificity, B-type natriuretic peptide >738.6 pg/dL had 48.5% sensitivity and 80.8% specificity, high-sensitivity C-reactive protein >1.8 mg/L had 94.9% sensitivity and 42.9% specificity, and bilirubin >15 mu mol/L had 78.2% sensitivity and 56.9% specificity. Nutritional status and appetite assessed by MNA/GNRI and CNAQ questionnaires showed poor correlations with other findings in HFrEF patients.