ArticleFrontiers in nutrition2024
Energy intake insufficiency due to underestimated energy requirement by common predictive formulas can be identified by urinary amino acid levels in advanced heart failure.
Article in Frontiers in nutrition, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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6 authors.
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Abstract
Background: Elevated resting energy expenditure (REE) promotes cachexia, worsening prognosis in patients with advanced heart failure (HF). However, adequate assessment of energy balance is challenging because of unvalidated common prediction methods and unestablished determinants of REE, resulting in a lack of biomarkers for predicting insufficient energy intake. Objective: This cross-sectional study aimed to evaluate REE in patients with advanced HF and explore biomarkers for insufficient energy intake. Methods: We measured REE by indirect calorimetry and calculated the total energy expenditure (TEE) of 72 hospitalized patients with advanced-stage HF. We compared these values with commonly-used formulas and analyzed the associations between REE per body weight (REEBW) and parameters related to hemodynamics and HF severity. In 17 of 72 patients, plasma amino acid (AA) and 24-h urinary AA concentrations were measured to analyze their correlations with energy balance, the ratio of caloric intake to REE. Results: Resting energy expenditure and TEE values were significantly higher than the predicted values. The mean REEBW was 25 kcal/kg/day, while that for the underweight (<18.5 kg/m Conclusion: Underweight patients with advanced HF require more energy per weight than the predicted value. Our proposed formula for pTEE in each BMI category may be useful in clinical practice to avoid underestimation of daily energy requirements. Inadequate energy intake, even with such an approach, may be identified by decreased urinary essential AA levels.
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