Nutritional Assessment Indices in Heart Failure with and without Reduced Exercise Tolerance

Background: Several nutritional assessment indices have been reported to be useful for predicting prognosis in patients with heart failure. However, the relationship between the nutritional assessment score and exercise tolerance has not been well acknowledged. The purpose of this study was to evaluate representative nutritional assessment indices in heart failure patients with and without reduced exercise tolerance, including geriatric nutritional risk index (GNRI), prognostic nutritional index (PNI), and controlling nutritional status score (CONUT). Methods: We enrolled consecutive 58 patients with heart failure who underwent both cardiopulmonary exercise and blood test. We divided them into group PET (preserved exercise tolerance : peak VO₂ > 14 ml/kg/min) and group RET (reduced exercise tolerance), and compared each index in the two groups. Results: PNI was more in group PET than group RET (51 points vs. 47 points, P = .02). However, GNRI and CONUT showed no significant differences (105 points vs.103 points, P = .38; 1.2 points vs. 2.0 points, P = .07, respectively). In the components of PNI, albumin was significantly different but total lymphocyte count showed no difference (4.1 vs. 3.9 g/dl, P < .01; 1834 vs. 1712/mm³, P = .46, respectively). Conclusion: Although GNRI and CONUT did not show any significant differences regardless of exercise tolerance, PNI was less in heart failure patients with reduced exercise tolerance than those with preserved exercise tolerance.