Serum Levels of Exocrine Pancreatic Enzyme in Patients with Acute Decompensated Heart Failure

Background: Acute decompensated heart failure (ADHF) can damage systemic organs through the poor perfusion and/or congestion. The interaction between ADHF and exocrine pancreatic function was rarely investigated. Methods: We compared admission levels of serum amylase or lipase (as suggestive of exocrine pancreatic function) between patients admitted for ADHF (N = 102) and those admitted for non-ADHF causes (N = 35). Correlates to amylase or lipase were assessed by multiple regression analysis. In HF patients, associations between low amylase or lipase levels and clinical outcomes (composite of all-cause mortality and/or ADHF rehospitalization) were analyzed in the multivariate Cox regression models. Results: ADHF patients had significantly lower serum levels of amylase (median, 54 IU/L versus 68 IU/L, P = .001) and lipase (25 IU/L versus 31 IU/L, P = .018) compared with non-HF group. Amylase correlated directly with blood urea nitrogen (BUN) (coefficient, 0.552; P < .001), albumin (coefficient, 0.233; P = .020), and inversely with BNP levels (coefficient, −0.227, P = .024). Lipase correlated directly with BUN (coefficient, 0.377; P < .001) and inversely with BNP levels (coefficient, −0.364; P < .001). Although there was no association between low amylase levels and clinical outcomes, low lipase levels (<18 IU/L) was significantly associated with worse clinical outcome (hazard ratio, 1.81; P = .025). Conclusion: ADHF patients may be suffering from exocrine pancreatic insufficiency, which can be associated with poor long-term clinical outcomes possibly through malnutrition.