Nutritional status of outpatients with chronic stable heart failure based on serum amino acid concentration

Background: Loss of skeletal muscle mass and low nutritional status are major complications of severe chronic heart failure (CHF) and have been associated with poor prognosis. This study aimed to identify the nutritional status of outpatients with CHF based on their body composition, such as skeletal muscle index (SMI) and serum amino acid concentration. Methods: We compared the body composition data and results of blood samples, including the serum amino acid concentration, of patients with CHF and those of controls. Results: No significant difference was found in total amino acid concentration between 105 patients with CHF (62% men, mean age: 71.0 +/- 11.0 years) and 106 controls (67% men, mean age: 69.1 +/- 9.4 years) (CHF: 3459.1 +/- 504.9 nmol/ml, control: 3575.8 +/- 513.1 nmol/ml; p = 0.072). However, the concentration of essential amino acids (EAA) (CHF: 949.5 +/- 197.9 nmol/ml, control: 1034.1 +/- 207.3 nmol/ml; p = 0.002) and branched-chain amino acid (BCAA) (CHF: 449.3 +/- 114.3 nmol/ml, control: 503.9 +/- 118.2 nmol/ml; p < 0.001) and Fischer's ratio (CHF: 2.86 +/- 0.62, control: 3.17 +/- 0.50; p < 0.001) were significantly lower in patients with CHF. Integrated analysis of these data revealed that SMI was negatively correlated with age [correlation coefficient (R), -0.313; 95% confidence interval (CI), -0.514 to -0.079; p = 0.010], but positively correlated with EAA concentration (R, 0.256; 95% CI, 0.017-0.467; p = 0.037), BCAA concentration (R, 0.362; 95% CI, 0.134-0.554; p = 0.003), and Fischer's ratio (R, 0.573; 95% Cl, 0.386-0.715; p < 0.001). Conclusions: Serum concentrations of EAA and BCAA and Fischer's ratio were lower in patients with CHF than in controls, while SMI correlated with EM, BCAA, and Fischer's ratio. (C) 2018 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.