Abstract
Introduction: Most patients with aortic stenosis (AS) are elderly and have multiple comorbidities. These conditions are often associated with poor nutrition and frailty. The purpose of this study was to assess the impact of preoperative nutritional status on symptoms and quality of life (QOL) after aortic valve replacement. Methods: We prospectively studied 220 patients with severe AS. Nutritional status was assessed using the Mini Nutritional Assessment (MNA) questionnaire. A score below 24 out of 30 indicates risk of malnutrition. Patients were evaluated preoperatively and three months after intervention. QOL was assessed using the RAND 36-item health survey. The six-minute walking test (6MWT) and the five times sit to stand test (5TSTS) were performed in 92 and 87 patients, respectively. Results: MNA score was below 24 in 28 % of the patients. Age, BMI, sex, and the proportion of patients undergoing surgery or TAVI were similar between MNA < 24 and MNA > 24 groups. There were no differences in NYHA class preoperatively, however a larger proportion of patients with MNA < 24 remained in NYHA 2 or higher after intervention (42 % vs 25 %, p = 0.03). They also remained more symptomatic, with dyspnea in 28 % vs 12 % (p = 0.01) and decreased exercise capacity in 44 % vs 16 % (p < 0.001) of the patients. Postoperative QOL was worse in patients with MNA < 24, with significant differences in seven categories (Figure). They performed worse in 6MWT at baseline (median 380 m vs 480 m, p = 0.02), but the difference was not significant after intervention (480 m vs 499 m, p = 0.4). Difference in 5TSTS was not significant at baseline (13.45 s vs 11 s, p = 0.1), but they performed worse after intervention (14.95 s vs 10.8 s, p = 0.02). Conclusions: Malnutrition is common among AS patients and is associated with worse QOL and more symptoms after intervention. Nutritional status should be assessed in AS patients before intervention for risk stratification and to find patients who might benefit from nutritional intervention.
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.