Cachexia Assessed by Serum Amino Acid Concentration in Chronic Stable Heart Failure Patients

Aims: Cachexia is a common complication of severe chronic heart failure (CHF). This study aimed to identify malnutrition in patients with CHF in terms of serum amino acid concentration. Methods and Results: We collected the data of serum concentrations of 40 amino acid factions, and compared between 108 CHF patients (62% men, age 71.1 ± 11.0 years) and 111 controls (66% men, age 69.0 ± 9.8 years). The serum concentrations of Valine, Isoleucine, Leucine, Tryptophan, Threonine, Histidine, Proline and α-Amino-n-butyric acid were significantly lower in CHF patients than controls, and those of Cystine, Taurine, Hydroxyproline, Citrulline, β-Alanine, β-Amino-iso-butyric acid, Ornithine, 1-Methyl-histidine, 3-Methyl-histidine, and NH3 were significantly higher. From these data, we calculated the serum concentration of total amino acid (TAA), essential amino acid (ESSAA), non-essential amino acid (NESSAA), Branched-chain amino acid (BCAA), and Fisher Ratio. There was no significant difference in the concentration of TAA (CHF 3472.6 ± 507.4 nmol/ml, control 3558.7 ± 516.6 nmol/ml, P = .187) and NESSAA (CHF 2524.9 ± 372.0 nmol/ml, control 2531.1 ± 363.9 nmol/ml, P = .682) between CHF patients and the controls, but the concentration of ESSAA (CHF 947.7 ± 196.4 nmol/ml, control 1027.6 ± 205.1 nmol/ml, P = .003), BCAA (CHF 448.4 ± 112.9 nmol/ml, control 500.1 ± 117.6 nmol/ml, P < .001), and Fischer ratio (CHF 2.88 ± 0.64, control 3.16 ± 0.53, P < .001) were significantly lower. Conclusion: The serum concentrations of ESSAA, BCAA and Fischer ratio were lower in CHF patients than the controls.