Abstract 4119926: Inadequate calorie and macronutrient intake in a population with congestive heart failure in a non-cardiovascular tertiary hospital.

Abstract

Listen

Translate article

Introduction: Chronic Heart Failure (HF) is a clinical syndrome that as a consequence of the compensatory mechanisms to maintain an adequate level of perfusion, causes dyspnea, peripheral edema, fatigue, lack of appetite, changes in body weight, cachexia, sarcopenia, among others. The presence of these signs and symptoms, with other factors such as restrictions on salt and water consumption, early satiety, and poor mobility, producing changes in the patient's nutritional status that can indirectly increase the risk of inadequate dietary intake, which over a prolonged period will lead to the development of nutritional deficiencies. Objective: To analyze the dietary intake of energy, macronutrients, and micronutrients of patients with chronic HF in outpatient care. Methods: Cross-sectional study, including 75 outpatients with HF, who attended a Heart Failure Clinic. Data collection on dietary intake was obtained using a multi-step 24-hour recall. The ESHA Food Processor program was used to calculate the energy, macronutrient, and micronutrient intake. The presence of congestion was evaluated by bioelectrical impedance vectorial analysis and VEXUS. Results: The baseline characteristics of the population are shown in Table 1. Of the total population, 34% presented with deficient caloric intake, and the subjects who presented congestion also ingested significant fewer calories compared with those who do not present congestion (p= 0.031). Only 15% of patients had an adequate protein intake that resulted in lower NYHA class; among those subjects with a deficient protein intake, 72% had congestion measured by VExUS or bioelectrical impedance. For the sodium intake in the subjects' diet, 45% exceeded the recommendation stated in the guidelines of less than 2,400 mg of sodium per day which was not statistically significant (p=0.077). Discussion and Conclusions: The inadequate intake of calorie or macronutrients in patients with CHF led the patients to more congestion and higher NYHA class, this provide a perspective on the importance of adequate nutritional advice by an expert in the area, which is also essential to improve the clinical course of heart failure. Likewise, future studies are deeded to investigate whether this poor dietary intake is inversely related to some clinical manifestations such as congestion, suggesting that improving these conditions could positively impact patients' volume status and improve functional class.