A novel echocardiographic index for prediction of malnutrition in acute heart failure

Abstract

Introduction Malnutrition is common among heart failure (HF) patients. The prognostic nutritional index (PNI) and controlling nutritional status (CONUT) are widely used for evaluation of nutritional status in HF patients. Right ventricular dysfunction, functional tricuspid regurgitation, and elevated right atrial pressure might exacerbate malnutrition by promoting bowel congestion and malabsorption in HF patients. We aimed to investigate the relationship between echocardiographic measures of right heart function and nutritional status in patients hospitalised for acutely decompensated HF, and to define a simple nutritional heart failure index based on non-invasively measured right heart functions to predict nutritional status. Methods 133 consecutive patients who were admitted to inpatient cardiology clinics for acutely decompensated HF were included in the study. All patients underwent a comprehensive echocardiographic examination on admission day. PNI and CONUT scores were calculated in order to assess the nutritional status. Results We defined a novel nutritional heart failure index (HFI-N) based on the echocardiographic measurements of inferior vena cava diameter (IVC), IVC collapsibility and right atrial pressure to predict the nutritional status of the patients. The HFI-N index was a significant predictor for both PNI and CONUT scores. In addition, both PNI and CONUT scores were significantly correlated to length of hospital stay. Conclusion Malnutrition was associated with a prolonged hospital stay in HF patients. The newly defined HFI-N index is a good predictor of the nutritional status in patients with heart failure.