Heart Failure

HF: Protein (2017)

• Intervention
  In patients with heart failure (NYHA Classes I–IV/AHA Stages B and C), what is the relationship between protein intake and nitrogen balance?

  • Conclusion
    In patients with heart failure (NYHA Classes I–IV/AHA Stages B and C) that are either normally nourished or malnourished, reported protein intakes ranging from 1.1g to 1.4g per kg of actual body weight per day resulted in positive nitrogen balance, while protein intakes ranging from 1.0g to 1.1g per kg of actual body weight per day resulted in negative nitrogen balance. Research is needed regarding the relationship between protein intake and nitrogen balance in patients with heart failure.
  • Grade: II
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: In patients with heart failure (NYHA Classes I to IV/AHA Stages B and C), what is the relationship between protein intake and nitrogen balance?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Aquilani R, Opasich C, Verri M, Boschi F, Febo O, Pasini E, Pastoris O. Is Nutritional Intake Adequate in Chronic Heart Failure Patients? J Am Coll Cardiol. 2003, 42 (7): 1,218-1,223.
      • Aquilani R, Opasich C, Gualco A, Verri M, Testa A, Pasini E, Viglio S, Iadarola P, Pastoris O, Dossena M, Boschi F. Adequate energy-protein intake is not enough to improve nutritional and metabolic status in muscle-depleted patients with chronic heart failure. European Journal of Heart Failure. 2008; 10:1127-1135.
  • Search Plan and Results: HF: Protein (2014)
     
  In patients with advanced heart failure (NYHA Class IV/AHA Stage D), what is the relationship between protein intake and nitrogen balance?

  • Conclusion
    In patients with advanced heart failure (NYHA Class IV/AHA Stage D), there were no studies identified that reported on the relationship between protein intake and nitrogen balance.
  • Grade: V
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Search Plan and Results: HF: Protein (2014)