Malnutrition Risk In Patients With Heart Failure With Preserved Ejection Fraction

Background Malnutrition is a strong risk factor for hospitalization and death in heart failure. The risk of malnutrition among patients with heart failure with preserved ejection fraction (HFpEF) and its associated clinical characteristics are undefined. Hypothesis Malnutrition risk is higher in patients with HFpEF than typical older adults. Methods Patients (n=98) consecutively enrolled in Michigan Medicine's HFpEF biorepository completed the short-form Mini-Nutritional Assessment (MNA) from May 2019 to March 2020. The 6-item MNA categorizes patients as malnourished, at-risk of malnourishment or normal nutritional status (scores of 0-7, 8-11, and 12-14, respectively) based on mobility, weight loss, food intake, stress and body mass index. Demographics, comorbidities, and number of hospitalizations within the previous year from the date of MNA were collected from electronic records. In a subset of participants (n=69), the Short Physical Performance Battery (SPPB), a measure of mobility and leg strength (scored 0-12, with lower scores indicative of frailty), was performed. Descriptive statistics, two-tailed t-tests and chi-square were used to compare clinical characteristics in normal versus at-risk or malnourished patients. Results Elevated nutritional risk (MNA ≤11) was present in 57% of patients with HFpEF (59% in women and 48% in men). No significant association was found between nutritional status and BMI, comorbidities, prior hospitalizations, or SPPB score (Table). Table. Association Between Nutritional Status and Clinical Characteristics Conclusions Despite high prevalence of obesity, outpatients with HFpEF frequently have or are at risk of malnutrition. In this study, BMI, comorbidities, previous hospitalizations, and frailty were not good surrogates for nutritional risk. Future work will clarify the prognostic impact of MNA score in HFpEF. Keywords: heart failure with preserved ejection fraction, nutrition,risk factors.