Abstract

Introduction: The important goal of heart failure (HF) management is to improve quality of life (QoL) and psychological status. Nutrition is a key component of HF management, but information on the impact of nutrition in HF is limited. Moreover, there is little evidence that nutritional status affects QoL and psychological status. Hypothesis: This study tested the hypothesis that nutritional status is associated with QoL and depressive symptoms in HF patients. Methods: A cross-sectional study was conducted in 102 HF patients (mean age: 68.4 ±13.1 years, male: 66%). QoL and depressive symptoms were assessed by the Minnesota Living with Heart Failure (MLWHF) questionnaire and Patient Health Questionnaire-9 (PHQ-9), respectively. Nutritional status was assessed by the Mini Nutritional Assessment (MNA) long version and patients were categorized as well nourished (≥24 points), at risk of malnutrition (17-23.5 points), or malnourished (<17 points). Data on sociodemographic and clinical characteristics were also collected. Multiple linear regression analysis was performed to evaluate the association of nutritional status with depression and QoL. Results: In total, 50% patients were at risk of malnutrition and 2% were malnourished. HF patients at risk of malnutrition were more likely to have a history of valve surgery, implantable cardiac defibrillation (ICD), or smoking. Risk of malnutrition was not associated with left ventricular ejection fraction (LVEF) or brain natriuretic peptide (BNP) (P = 0.100 and P = 0.173, respectively). Malnourished patients or those at risk of malnutrition had significantly lower QoL and more depressive symptoms than well-nourished patients (QoL: 14.2 ± 13.9 vs 23.2 ± 17.9, P = 0.007; depressive symptoms: 4.49 ± 4.7 vs 2.02 ± 2.9, P = 0.002). In multiple linear regression analysis, these significant associations remained after controlling for age, sex, HF etiology, smoking, ICD therapy, LVEF, and BNP. Conclusions: Risk of malnutrition was associated with lower QoL and higher depressive symptoms in HF patients. This study confirmed that good nutrition was an important goal in HF management. Further research is required to identify key nutrients and dietary habits affecting QoL and psychological status in HF patients.

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