Abstract
ABSTRACTObjectives:To evaluate the effect of enteral nutrition on heart function, inflammatory markers and immune function in elderly patients with chronic heart failure and its clinical significance.Methods:Eighty patients with moderate and severe heart failure admitted to the Cardiology Intensive Care Unit (CCU) of Baoding First Central Hospital from May 2019 to May 2020 were included in this study and randomly divided into two groups: the experimental group and the control group, with 40 patients in each group. The experimental group was given enteral nutrition support therapy on the basis of conventional therapy for one month, while the control group was given restricted salt and water intake on the basis of conventional therapy, and patients were given free diet according to their wishes. The changes in heart function before and after treatment, changes in inflammatory factors such as TNF-a, CRP, IL-6, changes in levels of immunoglobulins such as IgA, IgM, and IgG, and the improvement of the performance status of the two groups were compared and analyzed.Results:After treatment, indicators such as BNP, LVEDD, LVEF and 6min walking distance in the experimental group were significantly improved compared with the control group, with statistically significant differences (p<0.05), and the levels of inflammatory factors such as TNF-a, CRP and IL-6 in the experimental group were significantly reduced compared with those in the control group (p=0.00). The levels of IgG, IgA, IgM and other immunoglobulins in the experimental group improved more significantly after treatment than those in the control group, with statistically significant differences (IgG, IgA, p=0.00; IgM, p=0.01). Moreover, the experimental group was significantly superior to the control group in the improvement rate of performance status score (ECOG) after treatment (p=0.04); The incidence of gastrointestinal adverse reactions in the experimental group was 20%, and that in the control group was 15%. No statistically significant difference can be observed in the gastrointestinal tolerance of both groups (p=0.56).Conclusions:Reasonable enteral nutrition boasts a variety of benefits for the recovery of elderly patients with chronic heart failure. With reasonable enteral nutrition, the heart function of elderly patients with chronic heart failure can be significantly improved, inflammatory factors can be reduced, immunity and performance status can be enhanced, and gastrointestinal tolerance can be ameliorated without obvious gastrointestinal reactions.
Highlights
Chronic Heart Failure (CHF), as the final stage of the progression of a variety of cardiovascular diseases, is a clinical syndrome caused by changes in heart structure or function, decreased cardiacPak J Med Sci January - February 2022 Vol 38 No 1 www.pjms.org.pk 302 output, increased systemic or pulmonary venous pressure, and congestion due to various reasons.[1]
Eighty patients with moderate and severe heart failure admitted to the Cardiology Intensive Care Unit (CCU) of Baoding First Central Hospital from May 2019 to May 2020 were recruited and randomly divided into two groups, with 40 cases in each group. 19 males and females were divided into the experimental group, aged 60-75 years old, with an average of 68.89±4.46 years old. males and 18 females were divided into the control group, aged 63-73 years old, with an average of 68.05±3.10 years old
The changes of heart function indicators of the two groups before and after treatment are shown in Table-II, suggesting that there was no significant difference in brain natriuretic peptide (BNP), left ventricular end diastolic diameter (LVEDD), left ventricular ejection fraction (LVEF) and 6min walking distance between the two groups before treatment (p>0.05)
Summary
Chronic Heart Failure (CHF), as the final stage of the progression of a variety of cardiovascular diseases, is a clinical syndrome caused by changes in heart structure or function, decreased cardiacPak J Med Sci January - February 2022 Vol 38 No 1 www.pjms.org.pk 302 output, increased systemic or pulmonary venous pressure, and congestion due to various reasons.[1]. Patients with mucosal congestion in the gastrointestinal tract may suffer from nausea, anorexia, decreased appetite, inability to eat, etc., and malnutrition and a negative nitrogen balance may occur with the progression of the disease course, affecting the quality of life of patients.[2] Patients with long-term pulmonary congestion may suffer from impaired alveolar respiratory membrane function, resulting in insufficient oxygen diffusion and dyspnea.[3] These conditions are common in elderly patients It was believed by Jones et al.[4] that the prognosis of patients with CHF has a close bearing on their nutritional status. Enteral nutrition support therapy combined with conventional therapy is a potent regimen for the treatment of elderly patients with chronic heart failure, which has certain benefits on heart function and performance status of patients, and can improve the level of inflammatory factors and immune function of patients
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