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Rivera FB, Escolano BT, Nifas FM, Choi S, Carado GP, Lerma E, Vijayaraghavan K, Yu MG. Interrelationship of Sarcopenia and Cardiovascular Diseases: A Review of Potential Mechanisms and Management. J ASEAN Fed Endocr Soc 2023; 39:69-78. [PMID: 38863922 PMCID: PMC11163321 DOI: 10.15605/jafes.039.01.03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 05/30/2023] [Indexed: 06/13/2024] Open
Abstract
Sarcopenia refers to an age-related reduction of lean body mass. It showed a reciprocal relationship with cardiovascular diseases. Thus, it is imperative to explore pathophysiological mechanisms explaining the relationship between sarcopenia and cardiovascular diseases, along with the clinical assessment, and associated management. In this review, we discuss how processes such as inflammation, oxidative stress, endothelial dysfunction, neural and hormonal modifications, as well as other metabolic disturbances influence sarcopenia as well as its association with cardiovascular diseases. Moreover, this review provides an overview of both non-pharmacological and pharmacological management for patients with sarcopenia and cardiovascular diseases, with a focus on the potential role of cardiovascular drugs to mitigate sarcopenia.
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Affiliation(s)
| | | | | | - Sarang Choi
- Ateneo de Manila School of Medicine and Public Health, Pasig City, Philippines
| | - Genquen Philip Carado
- College of Medicine, University of the East Ramon Magsaysay Memorial Medical Center, Philippines
| | - Edgar Lerma
- Section of Nephrology, University of Illinois at Chicago College of Medicine, Chicago, Illinois, USA
| | | | - Marc Gregory Yu
- Section of Vascular Cell Biology, Joslin Diabetes Center and Harvard Medical School, Boston, USA
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Mebrahtom G, Hailay A, Aberhe W, Zereabruk K, Haile T. Rheumatic Heart Disease in East Africa: A Systematic Review and Meta-Analysis. Int J Rheumatol 2023; 2023:8834443. [PMID: 37767221 PMCID: PMC10522432 DOI: 10.1155/2023/8834443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Revised: 08/01/2023] [Accepted: 08/14/2023] [Indexed: 09/29/2023] Open
Abstract
Background Despite being a grave problem, there is little information on rheumatic heart disease's prevalence in East Africa. Therefore, the purpose of this systematic review and meta-analysis was to estimate the pooled prevalence of rheumatic heart disease in East Africa. Materials and Methods A computerized systematic search of using multiple database searching engines was performed in search of relevant English articles from the inception of the databases to December 2019. It was done in accordance with the preferred reporting items for systematic review and meta-analysis (PRISMA) standard. The funnel plot was used to assess publication bias. R and RStudio for Windows were used for all statistical analysis. The random-effect model was used for calculating the pooled estimate of the prevalence of rheumatic heart disease. Results The database search retrieved 1073 papers, and 80 articles (78 cross-sectional and two cohort study designs) with a total of 184575 individuals were found to be appropriate for the review. In East Africa, the overall prevalence of rheumatic heart disease was 14.67% (95% CI: 13.99% to 15.35%). In Ethiopia, Uganda, Tanzania, and Sudan, respectively, the subgroup analysis of rheumatic heart disease pooled prevalence was 22% (95% CI: 13% to 36%), 11% (95%t CI: 5% to 20%), 9% (95%t CI: 5% to 16%), and 3% (95%t CI: 1% to 10%), while the pooled prevalence of rheumatic heart disease in adults was 20% (95% CI: 12% to 30%), and in children, it was 4% (95% CI: 2% to 8%). Conclusions From this report, the prevalence of rheumatic heart disease in East Africa is very high, affecting about one in seven people. Therefore, future strategies should emphasize preventive measures at appropriate times to minimize the burden of this type of preventable heart disease.
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Affiliation(s)
- Guesh Mebrahtom
- Department of Adult Health Nursing, School of Nursing, Aksum University, Aksum, Ethiopia
| | - Abrha Hailay
- Department of Adult Health Nursing, School of Nursing, Aksum University, Aksum, Ethiopia
| | - Woldu Aberhe
- Department of Adult Health Nursing, School of Nursing, Aksum University, Aksum, Ethiopia
| | - Kidane Zereabruk
- Department of Adult Health Nursing, School of Nursing, Aksum University, Aksum, Ethiopia
| | - Teklehaimanot Haile
- Department of Maternity and Neonatal Nursing, School of Nursing, Aksum University, Aksum, Ethiopia
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Brecht P, Dring JC, Yanez F, Styczeń A, Mertowska P, Mertowski S, Grywalska E. How Do Minerals, Vitamins, and Intestinal Microbiota Affect the Development and Progression of Heart Disease in Adult and Pediatric Patients? Nutrients 2023; 15:3264. [PMID: 37513682 PMCID: PMC10384570 DOI: 10.3390/nu15143264] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 07/21/2023] [Accepted: 07/22/2023] [Indexed: 07/30/2023] Open
Abstract
Cardiovascular diseases (CVDs) are the leading cause of death worldwide, far ahead of cancer. Epidemiological data emphasize the participation of many risk factors that increase the incidence of CVDs, including genetic factors, age, and sex, but also lifestyle, mainly nutritional irregularities and, connected with them, overweight and obesity, as well as metabolic diseases. Despite the importance of cardiovascular problems in the whole society, the principles of prevention of CVDs are not widely disseminated, especially among the youngest. As a result, nutritional neglect, growing from childhood and adolescence, translates into the occurrence of numerous disease entities, including CVDs, in adult life. This review aimed to draw attention to the role of selected minerals and vitamins in health and the development and progression of CVDs in adults and children. Particular attention was paid to the effects of deficiency and toxicity of the analyzed compounds in the context of the cardiovascular system and to the role of intestinal microorganisms, which by interacting with nutrients, may contribute to the development of cardiovascular disorders. We hope this article will draw the attention of society and the medical community to emphasize promoting healthy eating and proper eating habits in children and adults, translating into increased awareness and a reduced risk of CVD.
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Affiliation(s)
- Peet Brecht
- Department of Cardiology, Medical University of Lublin, Jaczewskiego 8, 20-093 Lublin, Poland
| | - James Curtis Dring
- Department of Cardiology, Medical University of Lublin, Jaczewskiego 8, 20-093 Lublin, Poland
| | - Felipe Yanez
- Department of Cardiology, Medical University of Lublin, Jaczewskiego 8, 20-093 Lublin, Poland
| | - Agnieszka Styczeń
- Department of Cardiology, Medical University of Lublin, Jaczewskiego 8, 20-093 Lublin, Poland
| | - Paulina Mertowska
- Department of Experimental Immunology, Medical University of Lublin, 20-093 Lublin, Poland
| | - Sebastian Mertowski
- Department of Experimental Immunology, Medical University of Lublin, 20-093 Lublin, Poland
| | - Ewelina Grywalska
- Department of Experimental Immunology, Medical University of Lublin, 20-093 Lublin, Poland
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Zhuang C, Chen Y, Ruan J, Yu H, Zhu P, Zhu Y. Correlation between the prognostic nutritional index and outcomes in older patients aged ≥ 60 years with chronic heart failure. Int J Clin Pharm 2023; 45:163-173. [PMID: 36378403 DOI: 10.1007/s11096-022-01501-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 10/07/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND Nutritional status is related to clinical outcomes in patients with chronic heart failure (CHF). The prognostic nutritional index (PNI) is a simple tool to assess nutrition. AIM To evaluate the association between the PNI score and clinical outcomes in patients (60 years and older) hospitalized due to an acute exacerbation of CHF. METHOD This was a retrospective observational study. Patients hospitalized for acute CHF exacerbation between July 2015 and May 2020 were analyzed. Patients were followed until January 31, 2021. The primary end point was cardiovascular-related readmissions and all-cause mortality after hospital discharge. Secondary outcomes were factors associated with all-cause mortality. Patients were divided into normal nutrition (PNI > 38), moderate malnutrition (PNI = 35-38), and severe malnutrition (PNI < 35) groups. RESULTS The study included 355 patients (mean age 78 ± 9 years). The median follow-up was 769 days. Compared to survivors (n = 214), patients who expired (n = 133) were (1) older; (2) had lower PNI scores, lymphocyte counts, hemoglobin, albumin, total cholesterol, and serum sodium level; but (3) had higher serum creatinine levels, log(N-terminal-pro-B-type natriuretic peptide), and cardiac troponin I (P < 0.05). Multivariate analyses revealed that PNI was independently associated with all-cause mortality. The hazard ratio (HR) for moderate malnutrition versus normal nutrition was 1.624 (95% confidence interval [CI] 1.011-2.609, P = 0.045), while HR for severe malnutrition versus normal nutrition was 1.892 (95%CI 1.119-3.198, P = 0.017). Malnourished patients had significantly higher rates of cardiovascular readmissions and all-cause mortality. CONCLUSION Lower PNI (malnutrition) was associated with worse clinical outcomes and was independently associated with all-cause mortality in patients with CHF.
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Affiliation(s)
- Chenlin Zhuang
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, 350001, China.,Department of Medicine, Fujian Provincial Hospital South Branch, Fuzhou, 350028, China
| | - Yudai Chen
- Department of Digestive Endoscopy, Fujian Provincial Hospital South Branch, Fuzhou, 350028, China
| | - Junshan Ruan
- Department of Pharmacy, Fujian Provincial Hospital, Provincial Clinical College of Fujian Medical University, Fuzhou, China
| | - Huizhen Yu
- Department of Medicine, Fujian Provincial Hospital South Branch, Fuzhou, 350028, China. .,Key Laboratory of Geriatrics, Fujian Institute of Clinical Geriatrics, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, 350001, China.
| | - Pengli Zhu
- Key Laboratory of Geriatrics, Fujian Institute of Clinical Geriatrics, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, 350001, China
| | - YiZhun Zhu
- Department of Family Medicine, University Hospital, Macau University of Science and Technology, Macau, China
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Ahmed H, Tadesse A, Alemu H, Abebe A, Tadesse M. Undernutrition was a prevalent clinical problem among older adult patients with heart failure in a hospital setting in Northwest Ethiopia. Front Nutr 2022; 9:962497. [DOI: 10.3389/fnut.2022.962497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 11/10/2022] [Indexed: 12/04/2022] Open
Abstract
BackgroundUndernutrition is a frequently noticed medical problem in patients with heart failure. It is caused by poor nutrient intake, malabsorption, systemic inflammation, neurohumoral activation, oxidative stress, and hypermetabolic state. Undernutrition results in a decrease in the quality of life and the survival rate in patients with heart failure. There is a paucity of documentation on undernutrition among patients with heart failure in sub-Saharan African countries. The study aimed to determine the magnitude and associated factors of undernutrition among older adult patients with heart failure in the hospital setting in Northwest Ethiopia.MethodsAn institutional-based cross-sectional study was conducted at the University of Gondar Hospital, Northwest Ethiopia, between 1 June 2021 and 31 October 2021. A consecutive sampling method was used to recruit 262 study subjects. A Mini-nutritional assessment-full form (MNA-FL) Questionnaire was used to extract nutritional information among patients with heart failure. Patients with heart failure, who scored MNA-FL score <17, were declared to have undernutrition. The data were entered into EPI Info version 4.6.0.0 and then exported to SPSS version 26 for analysis. Explanatory variables associated with undernutrition in patients with heart failure were analyzed by applying a logistic regression model. A P-value of <0.05 was used to declare a significant association.ResultsA total of 262 patients with heart failure were included in the study. The mean age (± SD) of the study subjects was 64.6 (± 9.2) years. Hypertensive heart disease (111/262, 42%) was the most common cause of heart failure. Hypertension was the frequently observed comorbid disease. Based on the MNA-FL score for nutritional status, 75 out of 262 (28.6%, 95% CI: 22.9–34.4%) were undernourished (MNA-FL < 17), while 124 out of 262 (47.3%, CI: 41.5–53.1%) were at risk of undernutrition (MNA-FL = 17–23.5). The remaining 63 out of 262 (24.1%, 95% CI: 18.2–29.8%) study subjects were well nourished (MNA-FL > 24). On a multivariate analysis, patients with severe heart failure (New York Heart Association (NYHA) functional class III/IV) (AOR = 4.287, CI: 2.012–9.134, P-value < 0.001), with a duration of illness of 3–5 years (AOR = 3.225, CI: 1.138–9.137, P-value = 0.028), with a duration of illness of >5 years (AOR = 4.349, CI: 1.592–11.879, P-value = 0.001), presence of comorbidities (AOR = 2.29, CI: 1.06–4.96, P-value = 0.036), who underwent treatment with loop diuretics (AOR = 2.983, CI: 1.407–6.326, P-value = 0.040), and who reside in a rural area (AOR = 5.119, CI: 2.481–10.560, P-value < 0.001) were at risk of developing undernutrition.ConclusionUndernutrition was a significant clinical problem in older patients with heart failure. Nutritional interventions should be prioritized for patients with chronic and severe heart failure.
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Ni J, Fang Y, Zhang J, Chen X. Predicting prognosis of heart failure using common malnutrition assessment tools: A systematic review and meta-analysis. Scott Med J 2022; 67:157-170. [PMID: 36052423 DOI: 10.1177/00369330221122300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND AND AIMS COUNT score, PNI score, and GNRI scores are associated with cardiovascular events. This review identifies the most accurate malnutrition assessment tools based on these scores in predicting mortality and readmission outcomes in HF patients. MATERIAL AND METHODS PubMed via MEDLINE, EMBASE were searched to identify studies assessing malnutrition using CONUT, PNI and GNRI. A meta-analysis was carried out to pool the hazard ratios on mortality and readmission rates. The methodological quality was assessed using the Newcastle-Ottawa Scale. RESULTS The mortality in HF patients with malnutrition assessed by CONUT showed pooled HR of 1.23. HF patients with all severe, moderate, and mild risk of malnutrition showed mortality with HR 3.56, 2.71 and 1.57 respectively. For malnutrition assessed with GNRI, HF patients with all severe, moderate, and mild risk of malnutrition showed mortality with HR 4.17, 2.73 and 1.73 respectively. No significance difference in association of CONUT score with pooled HR of readmission rate was observed HR 0.99. With PNI, HF patients with all severe and moderate risk of malnutrition showed mortality with HR 2.14 and HR 1.68 respectively, although they failed to achieve significance. CONCLUSION CONUT and GNRI are the superior prognostic indicator than PNI in prediction of mortality associated with risk of malnutrition.
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Affiliation(s)
- Jianchao Ni
- Department of Geriatrics, 223524Affiliated Hospital of Shaoxing University, Shaoxing City, China
| | - Yuanyuan Fang
- Department of Geriatrics, 223524Affiliated Hospital of Shaoxing University, Shaoxing City, China
| | - Jianhai Zhang
- Department of Geriatrics, 223524Affiliated Hospital of Shaoxing University, Shaoxing City, China
| | - Xiaoyan Chen
- Department of General Physician, 74784Zhuji People's Hospital of Zhejiang Province, Zhuji, China
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Hussen NM, Workie DL, Biresaw HB. Survival time to complications of congestive heart failure patients at Felege Hiwot comprehensive specialized referral hospital, Bahir Dar, Ethiopia. PLoS One 2022; 17:e0276440. [PMID: 36264946 PMCID: PMC9584442 DOI: 10.1371/journal.pone.0276440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 10/07/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUNDS Congestive heart failure is a serious chronic condition when the heart's muscles become too damaged and a condition in which one or both ventricles cannot pump sufficient blood to meet the metabolic needs of the body. This study aimed to identify factors affecting the complications time of congestive heart failure patients treated from January 2016 to December 2019 at Felege Hiwot comprehensive specialized referral hospital in Bahir Dar, Ethiopia. METHODS A hospital-based retrospective data collection was collected from the medical charts of 218 randomly selected congestive heart failure patients. The Kaplan-Meier curve and the Cox proportional hazards model were used to compare and identify the factors associated with time to complication in patients with congestive heart failure. RESULTS The median complication time of congestive heart failure patients was 22 months [95% CI: 21.98-28.01]. About 194 (88.99%) of the patients were complicated. The Kaplan-Meier curve depicts the survival probability of complicated patients decreasing as the complication time increases. The hazard ratios for serum sodium concentration, left ventricular ejection fraction, patients from rural areas, age of patients, serum hemoglobin concentration, and New York heart association classes I, II, and III were given 0.94 [95% CI: 0.90-1.00], 0.74 [95% CI: 0.65-0.85], 0.75 [95% CI: 0.68-0.84], 1.28 [95% CI: 1.12-1.46], 0.89 [95% CI: 0.85-0.94], 0.44 [95% CI: 0.36-0.53], 0.54 [95% CI: 0.47-0.62] and 0.73 [95% CI: 0.65-0.81] respectively, and they are statistically associated with the complication time of congestive heart failure patients. CONCLUSIONS The median complication time of congestive heart failure patients was 22 months. This study strongly suggests that healthcare awareness should be strengthened earlier about the potential complications for patients with lower serum sodium concentrations below the threshold and aged congestive heart failure patients to reduce the risk of developing complications.
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Hua J, Lu J, Tang X, Fang Q. Association between Geriatric Nutritional Risk Index and Depression after Ischemic Stroke. Nutrients 2022; 14:nu14132698. [PMID: 35807878 PMCID: PMC9268883 DOI: 10.3390/nu14132698] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 06/25/2022] [Accepted: 06/26/2022] [Indexed: 02/04/2023] Open
Abstract
Background: Malnutrition is associated with poor outcomes after stroke. However, the association between malnutrition and post-stroke depression (PSD) remains unelucidated. We aimed to explore the association between geriatric nutritional risk index (GNRI) and depression after ischemic stroke. Methods: In total, 344 patients with ischemic stroke were included in this analysis. The GNRI was calculated from serum albumin level, weight, and height at admission. Malnutrition was defined using the GNRI cutoff points. A lower GNRI score indicates an elevated nutritional risk. The outcome was depression, measured 14 days after ischemic stroke. Logistic regression models were used to estimate the association between the GNRI and risk of PSD. Results: A total of 22.9% developed PSD 14 days after stroke. The mean GNRI was 99.3 ± 6.0, and 53.8% of the patients had malnutrition. After adjusting for covariates, baseline malnutrition was not associated with risk of PSD (OR, 0.670; 95%CI, 0.370–1.213; p = 0.186). The restricted cubic splines revealed a U-shaped association between the GNRI and PSD. Compared to moderate GNRI, higher GNRI (OR, 2.368; 95%CI, 0.983–5.701; p = 0.085) or lower GNRI (OR, 2.226; 95%CI, 0.890–5.563; p = 0.087) did not significantly increase the risk of PSD. Conclusion: A low GNRI was not associated with an increased risk of depression after ischemic stroke.
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Affiliation(s)
- Jianian Hua
- Department of Neurology, The First Affiliated Hospital of Soochow University, 899 Pinghai Road, Suzhou 215000, China; (J.H.); (J.L.)
- Medical College of Soochow University, 199 Renai Road, Suzhou 215123, China
| | - Jieyi Lu
- Department of Neurology, The First Affiliated Hospital of Soochow University, 899 Pinghai Road, Suzhou 215000, China; (J.H.); (J.L.)
- Medical College of Soochow University, 199 Renai Road, Suzhou 215123, China
| | - Xiang Tang
- Department of Neurology, The First Affiliated Hospital of Soochow University, 899 Pinghai Road, Suzhou 215000, China; (J.H.); (J.L.)
- Correspondence: (X.T.); (Q.F.)
| | - Qi Fang
- Department of Neurology, The First Affiliated Hospital of Soochow University, 899 Pinghai Road, Suzhou 215000, China; (J.H.); (J.L.)
- Correspondence: (X.T.); (Q.F.)
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Streng KW, Hillege HL, Ter Maaten JM, van Veldhuisen DJ, Dickstein K, Ng LL, Samani NJ, Metra M, Ponikowski P, Cleland JG, Anker SD, Romaine SPR, Damman K, van der Meer P, Lang CC, Voors AA. Clinical implications of low estimated protein intake in patients with heart failure. J Cachexia Sarcopenia Muscle 2022; 13:1762-1770. [PMID: 35426256 PMCID: PMC9178387 DOI: 10.1002/jcsm.12973] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 02/13/2022] [Accepted: 02/22/2022] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND A higher protein intake has been associated with a higher muscle mass and lower mortality rates in the general population, but data about protein intake and survival in patients with heart failure (HF) are lacking. METHODS We studied the prevalence, predictors, and clinical outcome of estimated protein intake in 2516 patients from the BIOlogy Study to TAilored Treatment in Chronic Heart Failure (BIOSTAT-CHF) index cohort. Protein intake was calculated in spot urine samples using a validated formula [13.9 + 0.907 * body mass index (BMI) (kg/m2 ) + 0.0305 * urinary urea nitrogen level (mg/dL)]. Association with mortality was assessed using multivariable Cox regression models. All findings were validated in an independent cohort. RESULTS We included 2282 HF patients (mean age 68 ± 12 years and 27% female). Lower estimated protein intake in HF patients was associated with a lower BMI, but with more signs of congestion. Mortality rate in the lowest quartile was 32%, compared with 18% in the highest quartile (P < 0.001). In a multivariable model, lower estimated protein intake was associated with a higher risk of death compared with the highest quartile [hazard ratio (HR) 1.50; 95% confidence interval (CI) 1.03-2.18, P = 0.036 for the lowest quartile and HR 1.46; 95% CI 1.00-2.18, P = 0.049 for the second quartile]. CONCLUSIONS An estimated lower protein intake was associated with a lower BMI, but signs of congestion were more prevalent. A lower estimated protein intake was independently associated with a higher mortality risk.
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Affiliation(s)
- Koen W Streng
- Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Hans L Hillege
- Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Jozine M Ter Maaten
- Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Dirk J van Veldhuisen
- Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Kenneth Dickstein
- University of Bergen, Bergen, Norway.,Stavanger University Hospital, Stavanger, Norway
| | - Leong L Ng
- Department of Cardiovascular Sciences, University of Leicester, Glenfield Hospital, and NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, UK
| | - Nilesh J Samani
- Department of Cardiovascular Sciences, University of Leicester, Glenfield Hospital, and NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, UK
| | - Marco Metra
- Institute of Cardiology, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Piotr Ponikowski
- Department of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland.,Cardiology Department, Military Hospital, Wroclaw, Poland
| | - John G Cleland
- National Heart and Lung Institute, Imperial College London, London, UK.,Robertson Centre for Biostatistics and Clinical Trials, University of Glasgow, Glasgow, UK
| | - Stefan D Anker
- Division of Cardiology and Metabolism, Charité Universitätsmedizin Berlin, Berlin, Germany.,Department of Cardiology (CVK), Charité Universitätsmedizin Berlin, Berlin, Germany.,Berlin-Brandenburg Center for Regenerative Therapies (BCRT), Charité Universitätsmedizin Berlin, Berlin, Germany.,German Centre for Cardiovascular Research (DZHK) partner site Berlin, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Simon P R Romaine
- Department of Cardiovascular Sciences, University of Leicester, Glenfield Hospital, and NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, UK
| | - Kevin Damman
- Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Peter van der Meer
- Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Chim C Lang
- Division of Molecular and Clinical Medicine, School of Medicine, University of Dundee, Dundee, UK
| | - Adriaan A Voors
- Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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Tang H, Gong F, Guo H, Dai Z, Wang J, Liu B, Li T, Tang X, Dong J, Pan S, Wang M, Sun Y, Qin B, Zhang J, Zhu X, Tian J, Fei Z, Lu G, Liu D. Malnutrition and Risk of Mortality in Ischemic Stroke Patients Treated With Intravenous Thrombolysis. Front Aging Neurosci 2022; 14:834973. [PMID: 35264946 PMCID: PMC8901046 DOI: 10.3389/fnagi.2022.834973] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 01/31/2022] [Indexed: 12/24/2022] Open
Abstract
Background and PurposeMalnutrition is highly prevalent in ischemic stroke patients. We aimed to investigate whether malnutrition indexes may be useful in predicting mortality at 90 days in ischemic stroke patients treated with intravenous thrombolysis.MethodsWe retrospectively analyzed consecutive patients who underwent thrombolytic therapy at three comprehensive stroke centers. Malnutrition was assessed using the controlling nutritional status (CONUT) score, geriatric nutritional risk index (GNRI), and prognostic nutritional index (PNI).ResultsOf 979 patients (mean age, 66.8 years; males, 63.6%) included in this study, 91 (9.3%; 95% confidence interval [CI]: 8.4–10.2%) died at 3-month follow up. According to the CONUT, GNRI, and PNI scores, 9.9, 33.7, and 7.0% of patients were moderately or severely malnourished, respectively; 64.0% were at least mildly malnourished by at least 1 malnutrition index. In the multivariate regression model after adjusting for potential confounders, malnutrition (severe risk versus normal nutritional status) was significantly associated with an increased risk of mortality for CONUT scores (adjusted odds ratio [OR] 16.16, 95%CI, 7.86-67.11; P < 0.001), GNRI scores (adjusted OR 9.82, 4.10-23.51; P < 0.001) and PNI scores (adjusted OR 12.74, 5.56-29.19; P < 0.001). Similar results were found when the malnutrition scores were analyzed as continuous variables. Adding the three malnutrition indexes to models containing conventional risk factors significantly improved risk reclassification for 3-month mortality.ConclusionOur study showed that malnutrition may be associated with a higher risk of mortality at 3 months in ischemic stroke after intravenous thrombolysis.
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Affiliation(s)
- Haiyan Tang
- Department of Neurology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Institute of Neurology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Fan Gong
- Department of Neurology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Institute of Neurology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Hongquan Guo
- Department of Neurology, Jinling Hospital, Southern Medical University, Nanjing, China
| | - Zheng Dai
- Department of Neurology, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi, China
| | - Jun Wang
- Department of Neurology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Institute of Neurology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Bin Liu
- Department of Neurology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Institute of Neurology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Tingting Li
- Department of Neurology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Institute of Neurology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xianbiao Tang
- Department of Rehabilitation Medicine, Puer Hospital of Traditional Chinese Medicine, Puer, China
| | - Junru Dong
- Changzhou Sports Medical Research Institute, Changzhou, China
| | - Song Pan
- Department of Medical Imaging, Shanxi Medical University, Taiyuan, China
| | - Mingzhe Wang
- Department of Neurology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Institute of Neurology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yan Sun
- Department of Neurology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Institute of Neurology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Baofeng Qin
- Department of Neurology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Institute of Neurology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jingsi Zhang
- Department of Neurology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Institute of Neurology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xuyin Zhu
- Department of Neurology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Institute of Neurology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jun Tian
- Department of Nursing, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Zhimin Fei
- Department of Neurosurgery, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Gendi Lu
- Department of Nursing, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
- *Correspondence: Gendi Lu,
| | - Dezhi Liu
- Department of Neurology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Institute of Neurology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Dezhi Liu,
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Ni Q, Wang X, Wang J, Chen P. The red blood cell distribution width-albumin ratio: A promising predictor of mortality in heart failure patients - A cohort study. Clin Chim Acta 2021; 527:38-46. [PMID: 34979101 DOI: 10.1016/j.cca.2021.12.027] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 11/30/2021] [Accepted: 12/28/2021] [Indexed: 12/23/2022]
Abstract
BACKGROUND Epidemiological studies suggest that increases in red blood cell distribution width (RDW) and decreases in albumin level can independently predict adverse cardiovascular outcomes. The prognostic value of RDW-albumin ratio (RAR), an innovate biomarker of inflammation, in heart failure (HF) patients has not been assessed. This study aimed to explore the association between RAR and mortality of HF patients. METHODS Data on patients diagnosed with HF were extracted from MIMIC-III database version 1.4. Cox proportional hazards models were used to investigate the associations between RAR and mortality of HF patients. HF patients admitted to the Second Affiliated Hospital of Wenzhou Medical University were also enrolled to explore the relationship between RAR and existing indicators of HF. RESULTS For 90-day mortality, the HR (95% CI) for the second (4.33<RAR<5.44) and the third (RAR>5.44) tertiles were 2.00 (1.58, 2.54) and 3.63 (2.91, 4.53), respectively, compared to the first tertile (RAR<4.33). When adjusted for age, gender and ethnicity in Model 1, the adjusted HR (95% CI) value of third tertiles was 3.66 (2.93, 4.56). Further adjust the vital signs, blood biochemical indicators, SOFA score and other parameters in Model II, the adjusted HR value of third tertiles was still statistically significant (HR: 2.70, 95% CI: 2.07-3.51, P < 0.0001). A similar trend was observed for 30-day, one-year mortality. For HF patients, high RAR significantly increased the risk of sepsis and requirement for renal replacement therapy. Additionally, there is a positive correlation between RAR, CRP levels, and NT-proBNP respectively. CONCLUSION High level of RAR is associated with increased short- and long-term mortality of patients with heart failure. The RAR is a promising biomarker that is easy to obtain and readily predicts mortality in heart failure patients.
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Affiliation(s)
- Qingwei Ni
- Department of Cardiology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Xueyuanxi Road, No.109, Wenzhou 325000, Zhejiang, China
| | - Xue Wang
- Department of Cardiology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Xueyuanxi Road, No.109, Wenzhou 325000, Zhejiang, China
| | - Jie Wang
- Department of Cardiology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Xueyuanxi Road, No.109, Wenzhou 325000, Zhejiang, China
| | - Peng Chen
- Department of Cardiology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Xueyuanxi Road, No.109, Wenzhou 325000, Zhejiang, China.
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12
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Lv S, Ru S. The prevalence of malnutrition and its effects on the all-cause mortality among patients with heart failure: A systematic review and meta-analysis. PLoS One 2021; 16:e0259300. [PMID: 34710169 PMCID: PMC8553374 DOI: 10.1371/journal.pone.0259300] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 10/15/2021] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE Malnutrition has a high occurrence in patients with chronic heart failure (CHF). The prevalence of malnutrition and its impact on all-cause mortality in patients with CHF were assessed using a meta-analysis. METHODS PubMed, Embase, the Cochrane Library, Web of Science, Medline, CBM, CNKI, WANFANG DATA, and VIP databases were searched to collect cross-sectional and cohort studies on malnutrition, and the prevalence and all-cause mortality of patients with CHF were determined. The time of retrieval was from the database establishment to May 2021. Two researchers independently performed screening of the literature, data extraction and assessed the risk of bias in the included studies. Then Stata 16.0 software was used for meta-analysis. RESULTS A total of 10 cross-sectional and 21 cohort studies were included, including 12537 patients with CHF. A meta-analysis demonstrated that the total prevalence of malnutrition in patients with heart failure was 46% (95% confidence interval [CI]: 0.43, 0.49). Compared to patients with non-malnutrition, malnutrition increased the risk of all-cause mortality in patients with CHF (hazard ratio = 2.15, 95% CI [1.89, 2.45], P < 0.05). DISCUSSION Current evidence suggests that the prevalence of malnutrition is high among patients with CHF. The risk of all-cause mortality in such patients can be increased by malnutrition. Therefore, the risk of malnutrition in patients with CHF should be considered to reduce the occurrence of adverse clinical outcomes.
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Affiliation(s)
- Shubin Lv
- The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang, China
| | - Songchao Ru
- The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang, China
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13
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Asrade M, Shehibo A, Tigabu Z. Magnitude of undernutrition and associated factors among children with cardiac disease at University of Gondar hospital, Ethiopia. BMC Nutr 2021; 7:43. [PMID: 34348799 PMCID: PMC8340477 DOI: 10.1186/s40795-021-00449-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Accepted: 06/11/2021] [Indexed: 11/26/2022] Open
Abstract
Background Undernutrition and cardiac disease are interconnected in a vicious cycle. Little is known about the effect of undernutrition on cardiac disease among children in low- and middle-income countries (LMICs). This study aimed to assess magnitude of undernutrition and associated factors among children with cardiac disease at University of Gondar hospital, northwest Ethiopia. Method This hospital-based cross-sectional study included children with cardiac disease presenting to the pediatric outpatient clinic at University of Gondar Hospital, Ethiopia. A self-administered questionnaire was administered to participating families, and medical records were reviewed. All participants who fulfill the inclusion criteria were included. Anthropometric measurements were made and the presence of malnutrition was diagnosed according to the WHO criteria. Associated factors of undernutrition analyzed by using binary logistic regression model. Variables with p-value ≤0.2 in bivariate analysis were fitted to the final multivariable analysis and those variables with p-value ≤0.05 were considered as having statistically significant association to the outcome variable. AOR and 95% confidence interval was calculated to assess the strength of association between the variables. Result A total of 269 patients participated in the study. 177 (65.7%) were undernourished, of whom 96 (54.5%) were underweight, 70 (39.7%) were stunted, and 95 (53.9%) were wasted. Pulmonary hypertension (adjusted odds ratio [AOR] = 3.82, 95%CI 1.80–8.10), NYHA/modified Ross class III and IV heart failure (AOR = 4.64, 1.69–12.72) and cardiac chamber enlargement (AOR = 2.91, 1.45–5.66) were associated with undernutrition. Conclusion Undernutrition is common among children with cardiac disease in northern Ethiopia. Children with pulmonary hypertension, high-grade heart failure, and cardiac chamber enlargement may warrant close follow-up for malnutrition.
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Affiliation(s)
- Mulat Asrade
- Department of Pediatrics and Child Health, University of Gondar Hospital, Gondar, Ethiopia
| | - Abdulkadir Shehibo
- Department of Pediatrics and Child Health, University of Gondar Hospital, Gondar, Ethiopia.
| | - Zemene Tigabu
- Department of Pediatrics and Child Health, University of Gondar Hospital, Gondar, Ethiopia
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Liu R, Shao W, Sun N, Lai JK, Zhou L, Ren M, Qiao C. Prevalence and the factors associated with malnutrition risk in elderly Chinese inpatients. Aging Med (Milton) 2021; 4:120-127. [PMID: 34250430 PMCID: PMC8251855 DOI: 10.1002/agm2.12143] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Revised: 12/07/2020] [Accepted: 12/07/2020] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Malnutrition is an under recognized, but common issue in elderly patients. This study aimed to investigate the prevalence of poor nutritional status and identify comprehensive geriatric assessment-based clinical factors associated with increased malnutrition risk to assessing malnutrition risk in hospitalized elderly patients in China. METHODS A total of 365 elderly hospitalized patients (178 women, 76.37 ± 7.74 years) undertook a comprehensive geriatric assessment (CGA), and have their nutritional status assessed using the short-form mini-nutritional assessment. RESULTS Among 365 patients, 32 (8.77%) were malnourished and 112 (30.68%) were at risk of malnutrition. A logistic regression analysis showed that age (odds ratio [OR], 1.59; 95% confidence interval [CI], 1.13-2.23), alcohol consumption (OR, 2.04; 95% CI, 1.19-3.48), presence or history of cancer or heart failure (OR, 3.48 and 2.86; 95% CI, 1.49-8.13 and 1.12-7.27), depression (OR, 2.86; 95% CI, 1.97-4.17), body mass index (OR, 5.62; 95% CI, 3.62-8.71), being dependent in activity of daily living (OR, 3.81; 95% CI, 2.61-5.57), a lower score in instrumental activities of daily living (OR, 3.01; 95% CI, 2.09-4.33), recent fall(s) (OR, 2.22; 95% CI, 1.37-2.91), cognitive impairment (OR, 1.81; 95% CI, 1.30-2.53), insomnia (OR, 1.49; 95% CI, 1.07-2.06), hemoglobin and albumin level (OR, 1.72 and 2.86; 95% CI, 1.17-2.50 and 1.53-5.36) were independent correlates of malnutrition in older patients. CONCLUSION Our study demonstrated that age, alcohol consumption, chronic diseases (cancer and heart failure), depression, body mass index, function status, recent fall(s), cognitive impairment, insomnia, and low hemoglobin and albumin levels were independently associated with malnutrition in these patients. Comprehensive geriatric assessment can provide detailed information of older patients and can be a useful tool for assessing malnutrition risk-associated factors.
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Affiliation(s)
- Rong Liu
- Department of Geriatrics Ward 2The First Hospital of Lanzhou UniversityLanzhouChina
| | - Wenchao Shao
- Department of Cardiology, Union Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
| | - Nianzhe Sun
- The First Clinical Medicine School of Lanzhou UniversityLanzhouChina
| | - Jonathan King‐Lam Lai
- Storr Liver Center, Westmead Institute for Medical ResearchUniversity of Sydney and Westmead HospitalSydneyNew South WalesAustralia
| | - Lingshan Zhou
- Department of Geriatrics Ward 2The First Hospital of Lanzhou UniversityLanzhouChina
| | - Man Ren
- Department of Geriatrics Ward 2The First Hospital of Lanzhou UniversityLanzhouChina
| | - Chendong Qiao
- Department of Geriatrics Ward 2The First Hospital of Lanzhou UniversityLanzhouChina
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Widyastuti N, Luthfiah NH, Ulfa R, Sulchan M, Anjani G, Widyastiti NS, Afifah DN, Almira VG. The effect of tempeh flour from tree bean (Parkia timoriana (dc) Merr.) seeds on lipid profile in protein-energy malnutrition rats. POTRAVINARSTVO 2021. [DOI: 10.5219/1525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Children with protein-energy malnutrition (PEM) need a food product that can be easily absorbed by the body because they have impaired nutrient utilization and lipid profile disorder. The provision of fermented products such as tempeh is an alternative approach. Seeds of tree bean (Parkia timoriana (DC) Merr.) are a good source of various nutrients needed by children with PEM. This study aimed to prove the effectiveness of the administration of tempeh flour from tree bean (Parkia timoriana (DC) Merr.) seeds on the lipid profile in PEM rats. PEM in rats was induced by a zero-protein diet containing granulated sugar (20 g), vegetable oil (1 g), and cornstarch (24 g). The animals were categorized into a normal control group (K+), a PEM group without treatment (K−); a group fed tempeh flour from tree bean (Parkia timoriana (DC) Merr.) seeds 1.5 g.kg-1 BW (P1); and a group fed tempeh flour from tree bean (Parkia timoriana (DC) Merr.) seeds 3 g.kg-1 BW (P2). The intervention was administered for 30 days. There was a significant increase in HDL levels (p = 0.001) and significant decreases in cholesterol (p = 0.001), triglyceride (p = 0.001), LDL levels (p = 0.001), and atherogenic index of plasma (AIP) (p = 0.000) in treatment groups. In conclusion, the administration of tempeh flour from tree bean (Parkia timoriana (DC) Merr.) seeds increases HDL levels and decreases cholesterol, triglycerides, and LDL level, and atherogenic index of plasma (AIP) in rats with PEM.
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Takikawa T, Sumi T, Takahara K, Ohguchi S, Oguri M, Ishii H, Murohara T. <Editors' Choice> Prognostic utility of multipoint nutritional screening for hospitalized patients with acute decompensated heart failure. NAGOYA JOURNAL OF MEDICAL SCIENCE 2021; 83:93-105. [PMID: 33727741 PMCID: PMC7938087 DOI: 10.18999/nagjms.83.1.93] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 07/22/2020] [Indexed: 11/30/2022]
Abstract
This study aimed to evaluate the impact of serial changes in nutritional status on 1-year events including all-cause mortality or rehospitalization owing to heart failure (HF) among hospitalized patients with acute decompensated HF (ADHF). The study subjects comprised 253 hospitalized patients with ADHF. The controlling nutritional status (CONUT) score was assessed both at hospital admission and discharge. The subjects were divided into three groups according to nutritional status using CONUT score: normal (0 and 1), mild risk (2-4), and moderate to severe risk defined as malnutrition (5-12). We observed nutritional status was improved or not. The incidence of malnutrition was 30.4% at hospital admission and 23.7% at discharge, respectively. Malnutrition was independently associated with 1-year events among hospitalized patients with ADHF. Presence or absence of improvement in nutritional status was significantly associated with 1-year events (P < 0.05), that was independent of percentage change in plasma volume in multivariate Cox regression analyses. We determined a reference model, including gender and estimated glomerular filtration rate, using multivariate logistic regression analysis (P < 0.05). Adding the absence of improvement in nutritional status during hospitalization to the reference model significantly improved both NRI and IDI (0.563, P < 0.001 and 0.039, P = 0.001). Furthermore, malnutrition at hospital discharge significantly improved NRI (0.256, P = 0.036) In conclusion, serial changes in the nutritional status evaluated on the basis of multiple measurements may provide more useful information to predict 1-year events than single measurement at hospital admission or discharge in hospitalized patients with ADHF.
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Affiliation(s)
- Tomonobu Takikawa
- Department of Cardiology, Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Takuya Sumi
- Department of cardiology, Ichinomiya Municipal Hospital, Ichinomiya, Japan
| | - Kunihiko Takahara
- Department of Cardiology, Kasugai Municipal Hospital, Kasugai, Japan
| | - Shiou Ohguchi
- Department of Cardiology, Kasugai Municipal Hospital, Kasugai, Japan
| | - Mitsutoshi Oguri
- Department of Cardiology, Kasugai Municipal Hospital, Kasugai, Japan
| | - Hideki Ishii
- Department of Cardiology, Graduate School of Medicine, Nagoya University, Nagoya, Japan
- Department of Cardiology, Department of Cardiology, Fujita Health University Bantane Hospital, Nagoya, Japan
| | - Toyoaki Murohara
- Department of Cardiology, Graduate School of Medicine, Nagoya University, Nagoya, Japan
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17
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Prognostic role of the controlling nutritional status score in acute ischemic stroke among stroke subtypes. J Neurol Sci 2020; 416:116984. [DOI: 10.1016/j.jns.2020.116984] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Revised: 06/05/2020] [Accepted: 06/08/2020] [Indexed: 11/17/2022]
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Saintrain MVDL, Sandrin RLESP, Bezerra CB, Lima AOP, Nobre MA, Braga DRA. Nutritional assessment of older adults with diabetes mellitus. Diabetes Res Clin Pract 2019; 155:107819. [PMID: 31425770 DOI: 10.1016/j.diabres.2019.107819] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Accepted: 08/14/2019] [Indexed: 01/12/2023]
Abstract
AIMS We aimed to screen the nutritional status of older adults with diabetes mellitus, seeking to outline the needs of this population group considering their socioeconomic status. METHODS Cross-sectional study of 246 diabetic people aged 65-94 years in Northeastern Brazil. Semi-structured questionnaires were used to collect sociodemographic, general health and lifestyle data. The Mini Nutritional Assessment was used to screen nutritional status. RESULTS Participants' mean age was 73 ± 6.4 years, and there was a predominance of women (56.5%). The mean duration of diabetes was 14.1 years (±9.6 years). Patients aged 80 years or older presented a 3.7-fold higher risk of malnutrition (p < 0.001), and those who were uneducated exhibited a 5.8-fold higher risk of malnutrition (p = 0.040). Patients with BMI of 18.6-24.9 km/m2 presented a 2.2-fold higher risk of malnutrition than overweight or obese patients (p < 0.001). Nutritional status was significantly associated with coronary artery disease (p = 0.010) and stroke (p < 0.001). Malnourished patients exhibited a 2.2-fold higher occurrence of infection in the past 6 months (p = 0.017) and 2-fold higher occurrence of foot injuries (p = 0.028) than their well-nourished peers. CONCLUSION Malnutrition in older diabetic patients exacerbates underlying diseases and contributes to unfavorable prognosis, particularly in the oldest old and in individuals with low levels of education.
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Affiliation(s)
- Maria Vieira de Lima Saintrain
- Public Health Graduation Program, University of Fortaleza - Unifor, Av. Washington Soares, 1321, Edson Queiroz, CEP 60.811-905, Fortaleza, Ceará, Brazil.
| | | | - Carina Bandeira Bezerra
- School of Medicine, University of Fortaleza - Unifor, Av. Washington Soares, 1321, Edson Queiroz, CEP 60.811-905, Fortaleza, Ceará, Brazil
| | - Ana Ofélia Portela Lima
- Public Health Graduation Program, University of Fortaleza - Unifor, Av. Washington Soares, 1321, Edson Queiroz, CEP 60.811-905, Fortaleza, Ceará, Brazil
| | - Marina Arrais Nobre
- School of Medicine, University of Fortaleza - Unifor, Av. Washington Soares, 1321, Edson Queiroz, CEP 60.811-905, Fortaleza, Ceará, Brazil
| | - Débora Rosana Alves Braga
- School of Dentistry, University of Fortaleza - Unifor, Av. Washington Soares, 1321, Edson Queiroz, CEP 60.811-905, Fortaleza, Ceará, Brazil
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Mahdavi-Roshan M, Salari A, Hasandokht T, Rahbar-Taramsari M. Malnutrition Status and Associated Factors in Cardiac Patients Admitted to Heart Hospital, in the North of Iran. Hosp Top 2019; 97:60-65. [PMID: 31050309 DOI: 10.1080/00185868.2019.1605864] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The objective of study was to evaluate the prevalence of malnutrition and associated factors in cardiac patients in the north of Iran. This cross-sectional study was done on 430 cardiac patients, who were admitted to the only heart hospital in the north of Iran. The malnutrition status was assessed based on "Malnutrition Universal Screening Tool" (MUST). The data was analyzed using SPSS software. The mean age of patients was 63.5 ± 12.67 years. The commonest cause of hospitalization was acute coronary syndrome. 31.4% patients had history of admission in the past 12 months. The prevalence of malnutrition was 14%, 7.7%, and 6.3% had medium and high risk of malnutrition, respectively. Patients with history of one time admission were 2.7 times more likely to be malnourished. The odds ratio for more than one time of hospital admission was 3.54. Malnutrition is likely to be present when the cardiac patients are admitted to hospital in Gilan province, in northern Iran.
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Affiliation(s)
- Marjan Mahdavi-Roshan
- a Cardiovascular Diseases Research Center, Faculty of Medicine , Guilan University of Medical Sciences , Rasht , Iran
- b Department of Community Medicine, School of Medicine , Guilan University of Medical Sciences , Rasht , Iran
| | - Arsalan Salari
- a Cardiovascular Diseases Research Center, Faculty of Medicine , Guilan University of Medical Sciences , Rasht , Iran
| | - Tolou Hasandokht
- a Cardiovascular Diseases Research Center, Faculty of Medicine , Guilan University of Medical Sciences , Rasht , Iran
- b Department of Community Medicine, School of Medicine , Guilan University of Medical Sciences , Rasht , Iran
| | - Morteza Rahbar-Taramsari
- c Department of Forensic Medicine , School of Medicine, Razi Teaching Hospital, Guilan University of Medical Sciences , Rasht , Iran
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Li K, Fu W, Bo Y, Zhu Y. Effect of albumin-globulin score and albumin to globulin ratio on survival in patients with heart failure: a retrospective cohort study in China. BMJ Open 2018; 8:e022960. [PMID: 29982222 PMCID: PMC6042582 DOI: 10.1136/bmjopen-2018-022960] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE To investigate the combined effect of albumin (ALB) and globulin (GLB) on the overall survival (OS) of patients with heart failure (HF). DESIGN Retrospective cohort study. SETTING A hospital. PARTICIPANTS 404 patients first diagnosed with HF. MEASUREMENTS Serum ALB and GLB were measured within 3 days after admission. The albumin to globulin ratio (AGR) was calculated as the ALB divided by the GLB. The receiver operating characteristic curve was used to calculate the cut-off points for ALB, GLB and AGR. Patients with low ALB levels (≤35.3 g/L) and high GLB levels (>27.0 g/L) were assigned an albumin-globulin score (AGS) of 2, those with only one of the two abnormalities were assigned an AGS of 1 and those with neither of the two abnormalities were assigned an AGS of 0. RESULTS The mean age of the 404 patients was 62.69±15.62, and 54.5% were male. 14 patients were lost to follow-up. 120 patients died from HF and 211 patients were readmitted to the hospital for worsening HF. Multivariate Cox regression analysis showed that higher AGR was significantly associated with favourable OS (HR, 0.61, 95% CI 0.38 to 0.98, p=0.040) but not AGS. CONCLUSION Serum levels of ALB and GLB are objective and easily measurable biomarkers which can be used in combination to predict the survival of patients with HF.
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Affiliation(s)
- Kuan Li
- Department of Infectious Disease, Henan Provincial People’s Hospital, Zhengzhou, China
| | - Wanrong Fu
- Department of Cardiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yacong Bo
- Department of Emergency, Henan Provincial People’s Hospital, Zhengzhou, China
| | - Yongjian Zhu
- Department of Emergency, Henan Provincial People’s Hospital, Zhengzhou, China
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Alvarez-Alvarez B, García-Seara J, Rodríguez-Mañero M, Iglesias-Alvarez D, Martínez-Sande JL, Agra-Bermejo RM, Fernández López XA, González-Melchor L, Gude Sampedro F, Díaz-Louzao C, González-Juanatey JR. Prognostic value of nutrition status in the response of cardiac resynchronization therapy. Indian Pacing Electrophysiol J 2018; 18:133-139. [PMID: 29649579 PMCID: PMC6090074 DOI: 10.1016/j.ipej.2018.04.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Revised: 03/03/2018] [Accepted: 04/05/2018] [Indexed: 11/17/2022] Open
Abstract
Background Cardiac resynchronization therapy (CRT) is indicated in symptomatic heart failure (HF) patients after achieving optimal medical therapy. However, there are still a large percentage of patients who do not respond to CRT. Malnutrition is a frequent comorbidity in patients with HF, and it is associated with a poorer prognosis. Here, we evaluate the nutritional status of patients assessed by Controlling Nutritional Status (CONUT) score and its association with structural remodeling and cardiovascular events. Methods We investigated the effect of CONUT on HF/death in 302 consecutive patients with a CRT device implanted between 2005 and 2015 in a single tertiary center. We categorized the patients into three groups: normal nutritional status (CONUT 0–1), mild malnutrition (CONUT 2–4) and moderate-severe malnutrition (CONUT ≥ 5). Changes in nutritional status were assessed in patients with mild-to-severe malnutrition prior to CRT. Results One hundred and forty-eight patients exhibited normal nutritional status (49.0%), 99 patients exhibited mild malnutrition (32.8%) and 55 patients exhibited moderate-severe malnutrition (18.2%). CONUT scores of at least 2 were associated with higher risk of HF/death compared with CONUT 0–1. Significant left ventricular (LV) reverse remodeling was noted in patients with better nutritional status. In addition, those malnutrition patients at baseline that improved nutritional state exhibited fewer HF/death events at follow-up. Conclusion CONUT score prior to CRT was an independent risk factor of death/HF and was correlated with LV reverse remodeling. Improvements in CONUT score during long-term follow-up were associated with a reduction in the rate of HF/death.
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Affiliation(s)
- Belén Alvarez-Alvarez
- Cardiology Department, Clinical University Hospital of Santiago de Compostela, CIBERCV, Spain.
| | - Javier García-Seara
- Arrhythmia Unit, Clinical University Hospital of Santiago de Compostela, CIBERCV, Spain
| | | | - Diego Iglesias-Alvarez
- Cardiology Department, Clinical University Hospital of Santiago de Compostela, CIBERCV, Spain
| | - Jose L Martínez-Sande
- Arrhythmia Unit, Clinical University Hospital of Santiago de Compostela, CIBERCV, Spain
| | - Rosa M Agra-Bermejo
- Cardiology Department, Clinical University Hospital of Santiago de Compostela, CIBERCV, Spain
| | | | | | | | - Carla Díaz-Louzao
- Epidemiology Department, Clinical University Hospital of Santiago de Compostela, Spain
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Zhou H, Qian H. Relationship between enteral nutrition and serum levels of inflammatory factors and cardiac function in elderly patients with heart failure. Clin Interv Aging 2018; 13:397-401. [PMID: 29563779 PMCID: PMC5846300 DOI: 10.2147/cia.s157507] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Objective To investigate enteral nutrition’s effect on serum inflammatory factors and the cardiac function of malnourished elderly patients with heart failure. Patients and methods A total of 105 elderly patients with heart failure were randomly divided into 3 groups: Treatment Group A, Treatment Group B, and the Control Group (Group C), each group having 35 patients and being administered conventional heart failure treatment. Group A was treated with 500 mL·d−1 of enteral nutrition for 1 month. Group B was given the same dose of enteral nutrition for 3 months. The Control Group was given free diet. Nutritional risk screening 2002 was used to assess the nutritional status before and after the treatment for each group. New York Heart Association status was recorded as were left ventricular ejection fraction, plasma B-type natriuretic peptide, inteleukin-6, C-reactive protein, and tumor necrosis factor-α. Results After the treatment, the body mass index, skinfold thickness of upper arm triceps, muscle circumference of the upper arm, upper arm muscle circumference, total protein, albumin, hemoglobin, and left ventricular ejection fraction in the treatment groups all increased, with relatively obvious relief of symptoms of heart failure. The levels of B-type natriuretic peptide, interleukin-6, tumor necrosis factor-α, and C-reactive protein all rose to different extents (P<0.05) and Treatment Group B showed more obvious improvement (P<0.01). Differences shown by the Control Group in each nutrition indicator, serum levels of inflammatory factors, and cardiac function had no statistical significance (P>0.05). Conclusion The use of enteral nutrition in conventional treatment of elderly patients with heart failure could improve not only patients’ nutritional status and cardiac function, but also their immune function, thus reducing the levels of inflammatory factors. The longer the treatment period is, the more obvious the improvement in patients’ cardiac function and inflammatory factors will be observed.
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Affiliation(s)
- Hong Zhou
- Department of General Surgery, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China.,Department of Gastrointestinal Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - HaiXin Qian
- Department of General Surgery, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China
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Tsega TA, Demissei BG. A systematic review of epidemiology, treatment and prognosis of heart failure in adults in Ethiopia. J Cardiovasc Med (Hagerstown) 2018; 19:91-97. [PMID: 29324479 DOI: 10.2459/jcm.0000000000000617] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Systematic characterization of heart failure in adults in Ethiopia is lacking currently. In this review, we sought to summarize the available scientific evidence on the epidemiology, treatment and prognosis of heart failure in adults in Ethiopia. METHODS A systematic review of PUBMED, EMBASE and SCOPUS was conducted for studies published between January 1990 and July 2017. Studies reporting on incidence, prevalence, treatment or prognosis of heart failure in individuals older than 14 years of age were included. RESULTS The search yielded 66 articles, out of which nine were found to be eligible for inclusion in this review. There are no studies reporting the incidence or prevalence of heart failure in the adult population in Ethiopia. There are, however, indications that heart failure might be a significant burden in the country, and typically affects middle-aged adults. Valvular heart disease, predominantly related to rheumatic heart disease, is the most commonly identified heart failure cause across the included studies. There are very limited data on treatment and prognosis. CONCLUSION There is limited scientific evidence on the epidemiology, treatment and prognosis of heart failure in adults in Ethiopia. Further studies are needed for the better understanding of the burden and treatment of heart failure in the adult population in Ethiopia.
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Giglio Canelhas de Abreu L, Proença Vieira L, Teixeira Gomes T, Bacal F. Clinical and Nutritional Factors Associated With Early Mortality After Heart Transplantation. Transplant Proc 2018; 49:874-877. [PMID: 28457415 DOI: 10.1016/j.transproceed.2017.01.045] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The aim of this work was to verify the association between clinical and nutritional factors and mortality in the 1st 30 days after heart transplantation. METHODS This was a retrospective study of patients who underwent heart transplantation in a public hospital in Brazil from January 2013 to August 2015. The clinical and nutritional factors analyzed were: body mass index, body surface area, cachexia, infection, duration of orotracheal intubation, ejection fraction, mean pulmonary pressure, Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) score, hemoglobin, and diabetes mellitus. The primary outcome was mortality in the 1st 30 days after heart transplantation, and secondary outcomes were infection, acute kidney insufficiency, and duration of orotracheal intubation. We performed chi-square test, unpaired t test, and logistic regression in the analyses. A P value of < .05 was considered to be significant. RESULTS The sample had 103 patients, of which 16 patients (15.53%) died within 30 days after heart transplantation. We observed a relationship between death and orotracheal intubation duration (P < .01), postoperative creatinine (P < .01), acute kidney injury (P < .01), and INTERMACS score (P = .01) in the bivariate analysis but not in the multivariate model. CONCLUSIONS Clinical and nutritional factors had no impact on mortality up to 30 days after heart transplantation in this study, although orotracheal intubation duration, postoperative creatinine, acute kidney injury, and INTERMACS score were individually associated with early death.
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Affiliation(s)
- L Giglio Canelhas de Abreu
- Dietic and Nutrition Department, Heart Institute (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
| | - L Proença Vieira
- Dietic and Nutrition Department, Heart Institute (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - T Teixeira Gomes
- Dietic and Nutrition Department, Heart Institute (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - F Bacal
- Heart Transplant Unit, Heart Institute (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
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Pediatric Heart Failure, Lagging, and Sagging of Care in Low Income Settings: A Hospital Based Review of Cases in Ethiopia. Cardiol Res Pract 2016; 2016:7147234. [PMID: 27974990 PMCID: PMC5128707 DOI: 10.1155/2016/7147234] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Revised: 08/17/2016] [Accepted: 10/05/2016] [Indexed: 01/19/2023] Open
Abstract
Introduction. Causes of acute heart failure in children range from simple myocarditis complicating chest infection to complex structural heart diseases. Objective. To describe patterns, predictors of mortality, and management outcomes of acute heart failure in children. Methods. In retrospective review, between February 2012 and October 2015 at a tertiary center, 106 admitted cases were selected consecutively from discharge records. Data were extracted from patients chart and analyzed using SPSS software package. t-test and statistical significance at P value < 0.05 with 95% CI were used. Result. Acute heart failure accounted for 2.9% of the total pediatric admissions. The age ranged from 2 months up to 14 years with mean age of 8 years. Male to female ratio is 1 : 2.1. Rheumatic heart disease accounted for 53.7%; pneumonia, anemia, infective endocarditis, and recurrence of acute rheumatic fever were the main precipitating causes. Death occurred in 19% of cases. Younger age at presentation, low hemoglobin concentration, and undernutrition were associated with death with P value of 0.00, 0.01, and 0.02, respectively. Conclusions and Recommendation. Pediatric heart failure in our settings is diagnosed mainly in older age groups and mostly precipitated due to preventable causes. Significant mortality is observed in relation to factors that can be preventable in children with underlying structural heart disease. Early suspicion and diagnosis of cases may reduce the observed high mortality.
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Kobal J, Cankar K, Pretnar J, Zaletel M, Kobal L, Teran N, Melik Z. Functional impairment of precerebral arteries in Huntington disease. J Neurol Sci 2016; 372:363-368. [PMID: 27817854 DOI: 10.1016/j.jns.2016.10.033] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Revised: 10/11/2016] [Accepted: 10/21/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND Cardiovascular pathology of Huntington disease (HD) appears to be complex; while microvascular dysfunction seems to appear early, deaths from cardiomyopathy and stroke might occur in the late phase of HD. METHODS Our study evaluated global risk factors for coronary heart disease (CHD), structure and function of precerebral arteries in 41 HD subjects and 41 matched controls. HD subjects were divided into groups by the United Huntington disease rating scale (presymptomatic-PHD, early-EHD, midstage-MHD and late-LHD). CHD risk factors assessment and Doppler examination of precerebral arteries were performed, including measurements of the carotid artery intima-media thickness (IMT), and parameters indicating local carotid artery distensibility (stiffness index β, pulse wave velocity, pressure strain elasticity module and carotid artery compliance). RESULTS In the HD and controls we identified a comparable number of non-obstructive plaques (<50% lumen narrowing). No obstructive plaques (>50% lumen narrowing) were found. There was significantly increased IMT in MHD. In PHD and EHD the parameters of arterial stiffness were significantly higher and the carotid artery compliance was significantly lower. CONCLUSIONS Our results reveal functional vascular pathology in PHD, EHD, and MHD. Precerebral arteries dysfunction in HD therefore appears to be mostly functional and in agreement with recently described autonomic nervous system changes in HD.
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Affiliation(s)
- Jan Kobal
- University Medical Centre Ljubljana, Division of Neurology, Ljubljana, Slovenia.
| | - Ksenija Cankar
- University of Ljubljana, Faculty of Medicine, Institute of Physiology, Ljubljana, Slovenia
| | - Janja Pretnar
- University Medical Centre Ljubljana, Division of Neurology, Ljubljana, Slovenia; University of Ljubljana, Faculty of Medicine, Department of Neurology, Ljubljana, Slovenia
| | - Marjan Zaletel
- University Medical Centre Ljubljana, Division of Neurology, Ljubljana, Slovenia
| | - Lucijan Kobal
- University of Ljubljana, Faculty of Medicine, Department of Neurology, Ljubljana, Slovenia
| | - Natasa Teran
- University Medical Centre Ljubljana, Division of Gynaecology and Obstetrics, Ljubljana, Slovenia
| | - Ziva Melik
- University of Ljubljana, Faculty of Medicine, Institute of Physiology, Ljubljana, Slovenia
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